Survey Request Form

Electronic Survey Request

CSHONS members in good standing, wishing to survey the membership for research purposes will be required to complete and submit the following request form. Please complete and submit the form below.

It will be reviewed by the Electronic Communications Chair for appropriateness and consistency with the values of the Society and either approved, approved with revision, or rejected. If approved, the survey will be emailed to the general membership via the CSOHNS office.

Important:

Authors must use a recognized software tool
Authors must include a cover letter with the survey.
Authors must include a copy of the approval letter from your institution’s Research Ethics Board.
Surveys will appear on our Survey Landing page for approximately 3 months and reminders will be included in subsequent emails.
This is an electronic mailing service only.

Survey Request Form

Name

First Last

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Outline the GOALS of the Investigation

This Survey has our Institution's Research Ethics Board Approval(Required)

Yes

Please upload a copy of the approval letter from your Institution's Research Ethics Board

Max. file size: 1 GB.

Link to copy of survey or attache file below.

Attach copy of survey

Max. file size: 1 GB.

The applicant affirms that the information in this form is complete and accurate to the best of his/her knowledge.(Required)

Yes