Study Recruitment Form

Principle investigator name and credentials

Contact info (phone # and/or email address)

Names of any other researchers involved

Affiliation (University or organization)

IRB Approval document

One file only.
100 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

Please provide information about the study. Make sure you address every bullet asked below.

Please provide information about the study. Make sure you address every bullet asked below.
	Please provide information about the study. Make sure you address every bullet asked below.	Item weight

more items

Title (required field)
Inclusionary and exclusionary criteria for the sample (required field)

Target sample size (required field)
Age range of sample (required field)
Detailed information about how individuals would participate in the study (required field)
Amount of time required to participate (required field)
Is travel required or can individuals participate virtually (required field)

Compensation for participants (optional)
Any possible harmful effects including psychological effects (required field)
How study is being funded and any possible conflicts of interest (required field)
Website (optional)
Proposed start and end date for recruitment and study (required field)

How does the study align with the mission of NDSS?

Recruitment graphic, flyer, or text

Unlimited number of files can be uploaded to this field.
100 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.