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Center for Autism Research & Education
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The purpose of this form is to gather contact information for people who might be interested in taking part in ASD-related research being conducted at UMass Lowell. The form includes some background questions about you / your child(ren) so that we can target any research study announcements more efficiently. Please skip any questions you would prefer not to answer.
Name of potential participant
Age of potential participant
Preferred method of contact
If yes, who gave the diagnosis? Check all that apply
Please add my name to the CARE participant pool
I understand that by being added to the participant pool I may receive announcements about upcoming studies at UMass Lowell that I / my child(ren) might be eligible for. I also understand that I am in no way obligated to participate in any of these studies, and that not participating would not result in penalty of any kind. I also understand that not participating will in no way effect current or future programs or opportunities at UMass Lowell. I can choose to remove my name and names of my child(ren) at any time.
Please check here to indicate that you understand and agree with this statement.
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