Personal Information

 *The number on your BC Health Care Card.
Expected format: DD-MON-YYYY

*Please provide your name as it appears on your BC Health Care Card
As we stated in the consent form, your personal information will not be released and all results from this study will be anonymous.

NOTE: The information you have entered in this page (PHN, Last name, First Name, plus your Birth date) will be required to continue where you left off.