PSP Healthcare Professional Panel – Registration Form

Welcome to Physician Survey Panel (PSP). By joining, you will have the opportunity to participate in healthcare market research studies that contribute to advancing medical knowledge. Please complete the form below.

First Name

Last Name

Gender

Date of Birth

Country of Residence

City

Contact Number (Enter country code, Numeric only)

Email Address

Alternate Email

Current Position/Title

Primary Specialty

Years of Practice [after residency]

Years

Months

Current Employer / Hospital / Clinic Name

Type of Practice

Medical Registration Number/NPI

Have you participated in healthcare market research before?

Preferred Language(s) of Communication

Preferred Incentive Method

What describes your best availability for research activity

How did you hear about us (PSP)?

Consent Form

We value and respect your privacy. The personal and professional information you provide will remain strictly confidential and will be stored securely in compliance with applicable data protection regulations (such as GDPR).

Your data will only be used for the purpose of inviting you to participate in relevant healthcare or consumer research studies. It will never be sold, shared, or disclosed to third parties without your explicit permission, except where legally required.

All responses are aggregated and used only for research and informational purposes, ensuring that no individual is personally identified in the reporting of results.

By proceeding, you acknowledge that you have read and understood this statement and agree to the secure processing of your information for research-related purposes.

I agree to join PSP's healthcare professional panel and consent to being contacted for relevant research studies in accordance with data privacy regulations.