Survey Application PeDRA Survey Application Review the PeDRA Survey Policy and complete the below application for your survey to be reviewed by PeDRA’s Studies Committee. Applicants are encouraged to watch PeDRA's Survey 101 webinar series and to consult with the PeDRA Biostatistician for guidance on building and conducting a successful survey. Please note that all surveys must be programmed through an online platform (e.g. SurveyMonkey, REDCap) and available via a dedicated hyperlink prior to submission. Goal for Survey Review (select all that apply) Feedback on Survey Approval as a PeDRA Survey Access to Members for Distribution Other Principal (Corresponding) Investigator First Name Last Name Degree(s) Email Primary Affiliation Is the Principal Investigator an Active Member of PeDRA?YesNo Co-Investigators Please list all co-investigators working with you on the survey. It's okay to provide only first and last name of each co-investigator. PeDRA may contact you for additional details later. Co-Investigator 1 First Last Degree(s) Affiliation Check here to add another investigator Co-Investigator 2 First Last Degree(s) Affiliation Check here to add another investigator Co-Investigator 3 First Last Degree(s) Affiliation Check here to add another investigator Co-Investigator 4 First Last Degree(s) Affiliation Check here to add another investigator Co-Investigator 5 First Last Degree(s) Affiliation To add more than five co-investigators, please attach as an additional document below. Survey Information Title IRB/REB StatusTo be submitted SubmittedApprovedExempt Survey Hypothesis (50 word max) Project Summary (250 word max) Estimated time to complete survey (in minutes) Funding sources Is this an industry survey? YesNoPlease review PeDRA's Survey Policy for detailed criteria regarding Industry surveys. Industry surveys will only be available for distribution to PeDRA Members. Survey Distribution to (select all that apply):PeDRA MembersSPD Members Survey Link Survey Document Use this field to upload a document of your survey (to allow for comments by reviewers). IRB/REB Approval Exemption Use this field to upload your IRB/REB determination letter. Additional Documents Use this field to upload any additional documents (combined in one file). Contact Information Last updated January 2022.
