ASD-CARC :: Take a survey

Thank you for wanting to help with our new mobile lab research! Without families like yours, none of our research would be possible. Please complete the form below to let us about your community and how you might be able to help with our Mobile Lab Research.
Participant Recruitment
	Would you be willing to help us find families in your area that might participate in our research?	Yes No
Fundraising or Sponsors
	Would you be interested in help us raise funds to support our research?	Yes No
	Do you know of any businesses in your area that may be willing to sponsor a mobile lab visit to your community?	Yes No
	ASD-CARC's mobile lab may also be able to attend various events in your community. Are there any upcoming events in your area that our mobile lab could attend?
Facilities
	Are there any campgrounds or facilities in your area that have the resources to support a recreational vehicle?	Yes No
Comments
	Are there any other ways you can help our research? Or, do you have any questions, concerns or comments?
Contact Information
	Name:
	Email:
	Phone Number:
	City:
	Province/State: