In some situations, individuals may wish to authorize another person to assist with their clinical trial communications, application review, or decision-making. The Authorized Representative section allows you to securely designate a trusted individual who may act on your behalf during the pre-screening or referral process, as permitted by applicable laws and platform guidelines.

This is optional. If you choose to skip this section, only you will be contacted and given access to your account.

Who Can Be an Authorized Representative

Your authorized representative may be a:

• Legal guardian
• Caregiver
• Family member
• Healthcare proxy
• Trusted friend or advocate

Before designating someone, ensure that the individual understands your clinical interests and is comfortable acting in a supportive or communication-based role, if contacted.

Information You’ll Need to Provide

To ensure secure and compliant handling of your data, the following details are required for your designated representative:

• Full Name
• Relationship to You (e.g., daughter, son, caregiver, legal guardian)
• Gender
• Date of Birth
• Primary Phone Number
• Alternate Phone Number (optional)
• Email Address

Providing accurate information is critical to ensuring the right person is contacted if needed.

When the Representative May Be Contacted

Your authorized representative may be contacted:

• If you are unreachable or unable to respond during the trial referral process
• If you have granted permission for them to receive trial-related updates
• In compliance with legal requirements (such as guardianship for minors or individuals with diminished capacity)

You can update or remove your authorized representative at any time through your profile settings.

Key Note: Designating a representative does not transfer your rights as a participant. All decisions regarding trial participation remain voluntary and must be made with clear, informed consent, whether directly by you or via a legally authorized proxy where applicable.