Thank you for wanting to participate! On this form you indicate if we can contact you for our study. 

What do I give permission for? 
Are you filling in this form? Then you give the researcher permission to contact you. After completing this form, you will receive an e-mail confirming the personal data you have filled in. 

What happens to my personal data? 
We will use the personal data you filled in on this form to call and e-mail you about the study. We do not share this personal data with other people. We will delete all personal data when we stop looking for participants for the study. This is no later than 1 September 2025.  

Can I participate in this study? 

  • Have you experienced an unintended pregnancy?  
  • Do you want to help others by sharing your story?  
  • Were you 18 years old or older during the pregnancy?  
  • Has it been at least one year since you gave birth or had an abortion?  
  • Is it less than 20 years ago that you gave birth or had an abortion?  

Then you can participate. We are looking forward to hear about your experiences. 

Fiom heeft jouw persoonsgegevens nodig voor de uitvoering van haar dienstverlening. We gebruiken jouw gegevens enkel voor de doeleinden waar je ze voor verstrekt en deze worden verwijderd na het einde van de dienstverlening. 


Het privacystatement wordt in een nieuw tabblad geopend.


Personal data

Permission to contact me