CUHK Medical Centre Limited

Your Name*

Gender*

Date of Birth*

Telephone No.*

Height (m)*

Weight (kg)*

I would like to receive gastrointestinal-related information from CUHK Medical Center

I am interested in participating health check or research organized by CUHK Medical Centre

I agree to provide my above information to CUHK Medical Centre for the use in research

I agree to be contacted by centre staff for preliminary consultation

Irritable Bowel Syndrome (IBS) Assessment