Healthcare Communication Research Application Form
Apply to participate in or submit your project for healthcare communication research. Please complete all sections for your application to be considered.
Applicant Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Professional Affiliation (Institution/Organization)
*
Position/Title
*
Research Project Title
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Brief Summary of Research Project
*
Research Objectives (select all that apply)
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Improve patient-provider communication
Evaluate communication tools/technologies
Assess health literacy interventions
Study communication barriers in healthcare
Other
Primary Research Methodology
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Qualitative (e.g., interviews, focus groups)
Quantitative (e.g., surveys, experiments)
Mixed Methods
Other
Target Population for Research
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Have you obtained or will you obtain ethical approval for this research?
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Yes, already obtained
Will obtain before starting
No, not required
Please upload any supporting documents (e.g., research proposal, CV, ethics approval letter)
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Signature (please sign to confirm your consent and application)
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Submit Application
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