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Department of Behavioral Science Survey Form

Instructions:

  To help us determine which studies you may be eligible for, please answer the questions on the following pages as completely as possible.

  On the last page you will be given the option to either leave your name and phone number so we can contact you or to enter a code and call us back in 1-2 days at 859-277-3799 using the code to find out if you are eligible.

Warning: If you choose to create a code and you forget it, we will not be able to retrieve it for you.

To begin the survey process click the "Next" button below.