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RESEARCH REQUEST INPUT FORM


If you are a researcher seeking input from survivors of intimate partner sexual violence, rape, domestic violence or other related area, please place your request in the form below. You may leave irrelevant fields blank, but please give as much information as possible.

Name:
Focus of Research (to be elaborated below):
You are looking for Respondents who are:
  • Survivors
  • Professionals
  • Both
Do you have the backing of an organization?
  • Yes
  • No
  • Not Relevant
Name of Organization:
Link to Organization:
All about the research:
What type of questions will respondents be asked (general elaboration):
Can respondents be anonymous?
  • Yes
  • No
  • Up to Respondent
In what country is the research based?
Do you need respondents from a specific geographical location (If yes, please elaborate):
Are you looking for a specific age group? (specify age group or just say "any")
How is information to be gathered?
  • Questionnaire / Survey
  • Face-to-Face Interview
  • Telephone Interview
  • Email Correspondence
  • Skype
  • Will discuss preference with respondent
Link to Questionnaire for Viewing and/or Download:
If you wish you may upload your research questions:
Specific instructions for Respondents?
What is the latest date you need respondents by?
E-mail address that respondents should contact you at:
Any final relevant information?