Design Science Participant Registration

Interested in usability research? We need your input!

Design Science is a third-party consulting firm specializing in medical device research. While the majority of our work involves this type of research, we are in need of participants with and without medical backgrounds.

The data you provide in this survey will give us a better understanding of your experience so we may contact you when your criteria meets the target study population. Your data will not be publicly shared. You may exit the survey and re-access it as many times as needed. Please answer all questions that apply to you.

https://dscience.com/

Question Title

* 1. If you are signing up for a particular study, please enter the project code.

Question Title

* 2. How did you hear about this study?

Question Title

* 3. First Name

Question Title

* 4. Last Name

Question Title

* 5. How did you hear about Design Science?

Fundraising Event

Referral

Social Media

Other (please specify)

Question Title

* 6. Date of Birth

Date / Time

Date

Question Title

* 7. Gender

Male

Female

Question Title

* 8. Email Address

Question Title

* 9. Home Phone

Question Title

* 10. Cell Phone

Question Title

* 11. Home Address (for honorarium payment purposes)

Question Title

* 12. Which best describes you? Please check all that apply.

Healthcare Professional

Patient

Caregiver

Other (please specify)

Question Title

* 13. If you are a healthcare professional, which best describes you?

Doctor

OB/GYN

Registered Nurse

Nurse Practitioner

Physician Assistant

Licensed Practical Nurse

Clinical Nurse

Certified Registered Nurse Anesthetist

Pharmacist

Pharmacy Technician

Other (please specify)

Question Title

* 14. If you are a specialist, please state your area of expertise (i.e., oncology pharmacist, trauma nurse, etc.)

Question Title

* 15. If you are a healthcare professional, please state which best applies to your workplace.

Hospital

Doctor's Office

Clinic

Other (please specify)

Question Title

* 16. If you are a patient and/or caregiver, does the condition require medication?

Yes

Question Title

* 17. Are you or the person you care for living with any of the following conditions?

Diabetes Type I

Diabetes Type II

Parkinson's Disease

Hemophilia A/B

Multiple Sclerosis

Alzheimer's

Arthritis

Atopic Dermatitis

Vision impairments

Dexterity impairments

Other (please specify)

Question Title

* 1. If you are signing up for a particular study, please enter the project code.

Question Title

* 2. How did you hear about this study?

Question Title

* 3. First Name

Question Title

* 4. Last Name

Question Title

* 5. How did you hear about Design Science?

Question Title

* 6. Date of Birth

Question Title

* 7. Gender

Question Title

* 8. Email Address

Question Title

* 9. Home Phone

Question Title

* 10. Cell Phone

Question Title

* 11. Home Address (for honorarium payment purposes)

Question Title

* 12. Which best describes you? Please check all that apply.

Question Title

* 13. If you are a healthcare professional, which best describes you?

Question Title

* 14. If you are a specialist, please state your area of expertise (i.e., oncology pharmacist, trauma nurse, etc.)

Question Title

* 15. If you are a healthcare professional, please state which best applies to your workplace.

Question Title

* 16. If you are a patient and/or caregiver, does the condition require medication?

Question Title

* 17. Are you or the person you care for living with any of the following conditions?

Question Title

* 18. Would you like to receive emails regarding upcoming studies?