Warning: Use of undefined constant navn - assumed 'navn' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 238

Warning: Use of undefined constant email - assumed 'email' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 240

Warning: Use of undefined constant adresse - assumed 'adresse' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 244

Warning: Use of undefined constant tlf - assumed 'tlf' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 246

Warning: Use of undefined constant by - assumed 'by' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 250

Warning: Use of undefined constant by2 - assumed 'by2' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 256

Warning: Use of undefined constant dato - assumed 'dato' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 286

Warning: Use of undefined constant height - assumed 'height' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 292

Warning: Use of undefined constant weight - assumed 'weight' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 298

Warning: Use of undefined constant sex - assumed 'sex' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 304

Warning: Use of undefined constant dbop - assumed 'dbop' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 304

Warning: Use of undefined constant nej - assumed 'nej' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 185

Warning: Use of undefined constant mand - assumed 'mand' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 185

Warning: Use of undefined constant sex - assumed 'sex' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 305

Warning: Use of undefined constant dbop - assumed 'dbop' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 305

Warning: Use of undefined constant nej - assumed 'nej' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 185

Warning: Use of undefined constant mand - assumed 'mand' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 185

Warning: Use of undefined constant unger - assumed 'unger' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 313

Warning: Use of undefined constant smoke1 - assumed 'smoke1' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 320

Warning: Use of undefined constant alkohol - assumed 'alkohol' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 330

Warning: Use of undefined constant rusmidler - assumed 'rusmidler' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 333

Warning: Use of undefined constant medicin - assumed 'medicin' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 339

Warning: Use of undefined constant motion - assumed 'motion' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 352

Warning: Use of undefined constant allergi - assumed 'allergi' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 380

Warning: Use of undefined constant typeallergi - assumed 'typeallergi' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 381

Warning: Use of undefined constant oto1 - assumed 'oto1' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 387

Warning: Use of undefined constant oto - assumed 'oto' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 389

Warning: Use of undefined constant eye1 - assumed 'eye1' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 394

Warning: Use of undefined constant eye - assumed 'eye' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 396

Warning: Use of undefined constant hud1 - assumed 'hud1' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 401

Warning: Use of undefined constant hud - assumed 'hud' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 403

Warning: Use of undefined constant hjerte1 - assumed 'hjerte1' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 410

Warning: Use of undefined constant hjerte - assumed 'hjerte' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 412

Warning: Use of undefined constant mavetarm1 - assumed 'mavetarm1' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 417

Warning: Use of undefined constant mavetarm - assumed 'mavetarm' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 419

Warning: Use of undefined constant hjerne1 - assumed 'hjerne1' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 424

Warning: Use of undefined constant hjerne - assumed 'hjerne' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 426

Warning: Use of undefined constant knogle1 - assumed 'knogle1' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 431

Warning: Use of undefined constant knogle - assumed 'knogle' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 433

Warning: Use of undefined constant nyre1 - assumed 'nyre1' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 439

Warning: Use of undefined constant nyre - assumed 'nyre' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 442

Warning: Use of undefined constant hormon1 - assumed 'hormon1' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 449

Warning: Use of undefined constant hormon - assumed 'hormon' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 452

Warning: Use of undefined constant psykisk1 - assumed 'psykisk1' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 458

Warning: Use of undefined constant psykisk - assumed 'psykisk' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 461

Warning: Use of undefined constant cancer1 - assumed 'cancer1' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 467

Warning: Use of undefined constant cancer - assumed 'cancer' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 470

Warning: Use of undefined constant andre - assumed 'andre' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 476

Warning: Use of undefined constant laegemidler - assumed 'laegemidler' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 494

Warning: Use of undefined constant dbop - assumed 'dbop' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 494

Warning: Use of undefined constant naale - assumed 'naale' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 495

Warning: Use of undefined constant dbop - assumed 'dbop' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 495

Warning: Use of undefined constant biopsier - assumed 'biopsier' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 496

Warning: Use of undefined constant dbop - assumed 'dbop' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 496

Warning: Use of undefined constant andref - assumed 'andref' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 497

Warning: Use of undefined constant betingelser - assumed 'betingelser' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 501

Warning: Use of undefined constant dbop - assumed 'dbop' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 501

Warning: Use of undefined constant dbop - assumed 'dbop' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 511

Warning: Use of undefined constant dbop - assumed 'dbop' (this will throw an Error in a future version of PHP) in /customers/1/1/0/forsoegsperson.dk/httpd.www/database.php on line 613

<HTML>
   <HEAD>
   <TITLE>DATABASE</TITLE>
<META HTTP-EQUIV="Content-Type" CONTENT="text/html; charset=ISO-8859-1">
<SCRIPT LANGUAGE="JavaScript1.2" TYPE="text/javascript">
<!--
function popitup1(url)
{
	newwindow=window.open(url,'name','height=720,width=560,top=100,left=100,scrollbars=yes');
	if (window.focus) {newwindow.focus()}
	return false;
}

// -->
</SCRIPT>
<SCRIPT LANGUAGE="JavaScript1.2" TYPE="text/javascript">
<!--
function popitup2(url)
{
	newwindow=window.open(url,'name','height=150,width=300,top=100,left=100,scrollbars=auto');
	if (window.focus) {newwindow.focus()}
	return false;
}

// -->
</SCRIPT>

   </HEAD>
   <BODY link="#0066CC" vlink="#0066CC" alink="#0066CC">
<TABLE CELLSPACING="0" bordercolor="#111111" CELLPADDING="3" WIDTH="100%">
  <TR>
    <TD ALIGN="center" VALIGN="middle" style="border-left-style: solid; border-left-width: 1; border-top-style: solid; border-top-width: 1; border-bottom-style: solid; border-bottom-width: 1">
     <IMG SRC="logo.jpg" WIDTH="42" HEIGHT="38" BORDER="0">

    </TD>
    <TD style="border-right-style: solid; border-right-width: 1; border-top-style: solid; border-top-width: 1; border-bottom-style: solid; border-bottom-width: 1">
    <p><font size="5" face="Copperplate Gothic Bold" color="#0066CC">Tilmelding til databasen</font></p><p style="line-height:150%"><br>Udfyld venligst nedenstående felter med din information. Det er vigtigt, at du læser vores <A HREF="betingelser.html" style="text-decoration:none" onClick="return popitup1('betingelser.html')";">betingelser</A>, inden du tager endelig stilling til, om du vil oprette din profil. Du kan til hver en tid, efter du har oprettet din profil, selv gå ind og slette den igen ved hjælp af din email og dit kodeord. Yderligere anbefales det at du læser den <A HREF="http://www.cvk.im.dk/cvk/site.aspx?p=18" style="text-decoration:none" target="_blank">information</a>, som den centrale videnskabsetiske komité har skrevet til forsøgspersoner. Nederst på siden kan du angive, om der er forsøg du ikke vil deltage i. Hvis du har spørgsmål eller kommentarer så send venligst en mail til <a href="mailto:database@forsoegsperson.dk" style="text-decoration:none">database@forsoegsperson.dk</a>.</p><p>Vi skal til slut bede dig om at udfylde felterne så korrekt og så ærligt som overhoved muligt. Hvis du lader et felt stå tomt betyder det 0 eller ingen. Det er afgørende for databasens brugbarhed, at alle data er fuldstændig sande.</p><p>På forhånd mange tak.</p>   		
   <form method="post" action="/database.php">
   <table border="0" cellpadding="5" cellspacing="0" width="90%">
<tr>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
     </tr>
     <tr>
       <td>Navn<FONT size='2' COLOR='#CC0000'>*</FONT>:</td>
       <td><INPUT TYPE="text" NAME="navn" SIZE="30" VALUE=></td>
       <td>Email<FONT size='2' COLOR='#CC0000'>*</FONT>:</td>
       <td><INPUT TYPE="text" NAME="email"  SIZE="30" VALUE=></td>
     </tr>
     <tr>
       <td>Adresse<FONT size='2' COLOR='#CC0000'>*</FONT>:</td>
       <td><INPUT TYPE="text" NAME="adresse" SIZE="30" VALUE=></td>
       <td>Tlf nummer<FONT size='2' COLOR='#CC0000'>*</FONT>:</td>
       <td><INPUT TYPE="text" NAME="tlf" SIZE="30" VALUE=></td>
     </tr>
     <tr>
       <td>Postnummer<FONT size='2' COLOR='#CC0000'>*</FONT>:</td>
       <td><INPUT TYPE="text" NAME="by" SIZE="30" VALUE=></td>
       <td></td>
       <td></td>
     </tr>
     <tr>
       <td>By<FONT size='2' COLOR='#CC0000'>*</FONT>:</td>
       <td><INPUT TYPE="text" NAME="by2" SIZE="30" VALUE=></td>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
     </tr>
     <tr>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
     </tr>
     <tr>
       <td>Personligt kodeord (min. 6 tegn, både bogstaver og tal)<FONT size='2' COLOR='#CC0000'>*</FONT>:</td>
       <td><INPUT TYPE="PASSWORD" NAME="kodeord1" SIZE="30"></td>
       <td>&nbsp;</td>
       <td>Felter markerede med <FONT size='2' COLOR='#CC0000'>*</FONT> <b>skal</b> udfyldes.</td>
     </tr>
     <tr>
       <td>Gentag kodeord<FONT size='2' COLOR='#CC0000'>*</FONT>:</td>
       <td><INPUT TYPE="PASSWORD" NAME="kodeord2" SIZE="30"></td>
       <td>&nbsp;</td>  
       <td>&nbsp;</td>
     </tr>
     <tr>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
     </tr>
     <tr>
       <td>Fødselsdato (dd-mm-åååå)<FONT size='2' COLOR='#CC0000'>*</FONT>:</td>
       <td><INPUT TYPE="text" NAME="dato" SIZE="30" VALUE=></td>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
     </tr>
     <tr>
       <td>Højde (cm)<FONT size='2' COLOR='#CC0000'>*</FONT>:</td>
       <td><INPUT TYPE="text" NAME="height" SIZE="30" VALUE=></td>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
     </tr>
     <tr>
       <td>Vægt (kg)<FONT size='2' COLOR='#CC0000'>*</FONT>:</td>
       <td><INPUT TYPE="text" NAME="weight" SIZE="30" VALUE=></td>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
     </tr>
     <tr>
       <td>Køn:</td>
       <td>kvinde <INPUT TYPE="radio" NAME="sex" SIZE="30" value="kvinde" > mand 
       <INPUT TYPE="radio" NAME="sex" value="mand" checked></td>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
     </tr>
     <tr>
       <td>Antal børn inklusiv igangværende 
       graviditet:</td>
       <td>
       <INPUT TYPE="text" NAME="unger" SIZE="30" VALUE=></td>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
     </tr>
     <tr>
       <td>Hvor mange cigaretter/cigarer/piber tobak ryger du dagligt?</td>
       <td>
<INPUT TYPE="text" NAME="smoke1" SIZE="30" VALUE=>
	</td>
       <td>
	</td>
       <td>
       </td>
     </tr>
     <tr>
       <td>Alkoholforbrug (antal genstande ugentlig):</td>
       <td>
       <INPUT TYPE="text" NAME="alkohol" SIZE="30" VALUE=></td>
       <td>Andre rusmidler:</td>
       <td>
       <INPUT TYPE="text" NAME="rusmidler" SIZE="30" VALUE=></td>
     </tr>
     <tr>
       <td>Hvilken medicin får du regelmæssigt? Alle 
       typer inklusiv p-piller</td>
       <td>
       <INPUT TYPE="text" NAME="medicin" SIZE="30" VALUE=></td>
       <td></td>
       <td></td>
     </tr>
     <tr>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
     </tr>
     <tr>
       <td>Antal hele timer om ugen du dyrker motion 
       (inklusiv transport via cykel) :</td>
       <td><INPUT TYPE="text" NAME="motion" SIZE="30" VALUE=></td>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
     </tr>
     <tr>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
     </tr>
     <tr>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
     </tr>
   </table>

<table border="0" cellpadding="5" cellspacing="0" width="90%">
   
 <tr>
      <td width="45%"><h3>Eventuelle lidelser og sygdomme</h3></td>
      <td width="31%"><A HREF="nu.html" style="text-decoration:none" onClick="return popitup2('nu.html')";"><b>Nuværende</b></A> sygdomme skrives nedenfor:</td>
      <td width="24%"><A HREF="tid.html" style="text-decoration:none" onClick="return popitup2('tid.html')";"><b>Tidligere</b></A> sygdomme skrives nedenfor:</td>
 </tr>
      <tr>
      <td>Allergier:</td>
      <td>
<INPUT TYPE="text" NAME="allergi" SIZE="30" VALUE=>	</td>
      <td><INPUT TYPE="text" NAME="typeallergi" SIZE="30" VALUE=>	</td>
      </tr>
      
<tr>
      <td>Lidelser i øre, næse eller hals:</td>
      <td>
<INPUT TYPE="text" NAME="oto1" SIZE="30" VALUE=></td>
	<td>
      <INPUT TYPE="text" NAME="oto" SIZE="30" VALUE=></td>
      </tr>
<tr>
      <td>Lidelser i øjne:</td>
      <td>
<INPUT TYPE="text" NAME="eye1" SIZE="30" VALUE=></td>
	<td>
      <INPUT TYPE="text" NAME="eye" SIZE="30" VALUE=></td>
      </tr>
<tr>
      <td>Hud og kønssygdomme:</td>
      <td>
<INPUT TYPE="text" NAME="hud1" SIZE="30" VALUE=></td>
	<td>
      <INPUT TYPE="text" NAME="hud" SIZE="30" VALUE=></td>
      </tr>
<tr>

      <td>Hjerte-kar- eller lungesygdomme: (Inklusiv højt/lavt blodtryk)
	</td>
      <td>
<INPUT TYPE="text" NAME="hjerte1" SIZE="30" VALUE=>	</td>
      <td>
      <INPUT TYPE="text" NAME="hjerte" SIZE="30" VALUE=></td>
      </tr>
      <tr>
      <td>Sygdomme i mave-tarmkanalen:</td>
      <td>
<INPUT TYPE="text" NAME="mavetarm1" SIZE="30" VALUE=></td>
	<td>
      <INPUT TYPE="text" NAME="mavetarm" SIZE="30" VALUE=></td>
      </tr>
      <tr>
      <td>Lidelser i hjerne eller nerver:</td>
      <td>
 <INPUT TYPE="text" NAME="hjerne1" SIZE="30" VALUE=>	</td>
      <td>
      <INPUT TYPE="text" NAME="hjerne" SIZE="30" VALUE=></td>
      </tr>
      <tr>
      <td>Lidelser i knogler eller muskler:</td>
      <td>
<INPUT TYPE="text" NAME="knogle1" SIZE="30" VALUE=>	</td>
      <td>
      <INPUT TYPE="text" NAME="knogle" SIZE="30" VALUE=>
</td>
      </tr>
      <tr>
      <td>Lidelser i nyre eller urinveje:</td>
      <td>
 <INPUT TYPE="text" NAME="nyre1" SIZE="30" VALUE=>
</td>
      <td>
      <INPUT TYPE="text" NAME="nyre" SIZE="30" VALUE=>
</td>
      </tr>
      <tr>
      <td>Hormonelle forstyrrelser: (inklusiv sukkersyge og forstyrrelser i stofskiftet)
</td>
       <td>
<INPUT TYPE="text" NAME="hormon1" SIZE="30" VALUE=>
	</td>
      <td>
      <INPUT TYPE="text" NAME="hormon" SIZE="30" VALUE=>
</td>
      </tr>
      <tr>
      <td>Psykiske sygdomme:</td>
      <td>
<INPUT TYPE="text" NAME="psykisk1" SIZE="30" VALUE=>
	</td>
      <td>
      <INPUT TYPE="text" NAME="psykisk" SIZE="30" VALUE=>
</td>
      </tr>
      <tr>
      <td>Kræft:</td>
      <td>
<INPUT TYPE="text" NAME="cancer1" SIZE="30" VALUE=>
</td>
      <td>
      <INPUT TYPE="text" NAME="cancer" SIZE="30" VALUE=>
</td>
      </tr>
      <tr>
      <td>Andre sygdomme?</td>
      <td>
      <INPUT TYPE="text" NAME="andre" SIZE="30" VALUE=>
</td>
      <td>&nbsp;</td>
      </tr>
      <tr>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
       <td>&nbsp;</td>
     </tr>
 
   </table>

   

<input type="hidden" name="dbop" value="jatak" size="20">
<br><br>
<center>
<BIG>Jeg vil <B>ikke</B> deltage i forsøg med:</BIG><br>
<A HREF="laegemidler.html" style="text-decoration:none" onClick="return popitup2('laegemidler.html')";">Lægemidler?</A>&nbsp;<INPUT TYPE="Checkbox" NAME="laegemidler" VALUE="ja" >&nbsp;&nbsp;&nbsp;&nbsp;
<A HREF="naale.html" style="text-decoration:none" onClick="return popitup2('naale.html')";">Nåle?</A>&nbsp;<INPUT TYPE="Checkbox" NAME="naale" VALUE="ja" >&nbsp;&nbsp;&nbsp;&nbsp;
<A HREF="biopsier.html" style="text-decoration:none" onClick="return popitup2('biopsier.html')";">Biopsier?</A>&nbsp;<INPUT TYPE="Checkbox" NAME="biopsier" VALUE="ja" >&nbsp;&nbsp;&nbsp;&nbsp;
<A HREF="andre.html" style="text-decoration:none" onClick="return popitup2('andre.html')";">Andre?</A>&nbsp;<INPUT TYPE="text" NAME="andref" SIZE="30" VALUE=>

<br><br>
<br>
<INPUT TYPE="Checkbox" NAME="betingelser" VALUE="accept" >&nbsp;Jeg har læst og forstået <A HREF="betingelser.html" style="text-decoration:none" onClick="return popitup1('betingelser.html')";">betingelserne</A>.<br><br>
<input type=submit name="submit" value="Tilmeld">
</center> 

   </FORM>
    </TD>
  </TR>
</TABLE>

      
   </BODY>
   </HTML>