Membership Survey

Welcome to Myositis Clinical Trial Consortium (MCTC)!

We truly believe that your contributions would greatly benefit patients with myositis and foster valuable connections within the community and the collective efforts in advancing the clinical trials and related research on all forms of myositis.

Please fill out the form to join MCTC.

Thank you!

PRIVACY STATEMENT: The Myositis Clinical Trials Consortium (MCTC) securely collects and stores members' and collaborators' information via RedCaps. Personal data will not be shared without individuals' express consent. Anonymized data will be used for membership assessments, research, and collaborations to support MCTC's goals. Participants may opt to withdraw their consent and remove their information from the registry at any time by contacting the MCTC registry manager (Myositis.MCTC@gmail.com)

Member name

First Name:
Middle Name:
Last Name:

Email Address:

* must provide value

Phone Number:

Role:

* must provide value

Specialty:

* must provide value

Rheumatology

Neurology

Pulmonology

Dermatology

Neuromuscular

Others (please specify) ___________

reset

Other:

* must provide value

Other:

* must provide value

Site/Institution/Organization Name:

* must provide value

Country / Region

* must provide value

State:

City

* must provide value

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.