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Research Participant Intake

Structured intake with consent, for the start of an academic study.

5 questions

Signature

1. I consent to participate in this research study

Required
Number

2. Age

Required
Single choice

3. Gender

  • Female
  • Male
  • Non-binary
  • Prefer not to say
  • Other
Single choice

4. Highest level of education completed

  • High school
  • Some college
  • Bachelor's degree
  • Graduate degree
Long text

5. Do you have any relevant prior experience with this topic?

Use this template