Please read the following, tick the appropriate boxes then click 'submit' (*not yet functioning*)
(Or print out a copy, fill it in and post it to us)
*Name:
email address:
I would like more information before I decide to take part in the study. Please give us a contact number below.
I would like to take part in the study. Please complete the information below.
Please tell us if you are the child's primary or secondary parental caregiver:
I am the primary secondary parental caregiver (parent, foster parent, adoptive parent etc., primarily responsible for the day-to-day care) of a child with special needs (age 4-17 years only)
Please tell us whether your child with special needs has another parental caregiver, and whether they would also be willing to participate in the research:
My child with special needs has another caregiver.
yes no
If yes, this is the person willing to participate in the research?
If yes, please include their contact details below.