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VAPAUS - Phase 3 Clinical Study

If you are interested in learning more from a trial site coordinator about participating in the Palvella Phase 3 Clinical Trial to evaluate PTX-022 in PC, please fill out the information below:
Contact Information *This question is required.
What is your affected gene? *This question is required.
Do you have your genetic testing report? *This question is required.
Have you been in a clinical trial in the past? Please select all that apply. *This question is required.
Are you willing to travel four different times during the trial? *This question is required.
(enter your initials in box)
Signature *This question is required.
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This question requires a valid date format of MM/DD/YYYY.
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