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Thank you for your interest in participating in research with the Sensory, Cognitive, and Affective Neurodevelopment (SCAN) Lab! We have a number of different studies across all ages focused on understanding typical and atypical brain, body, and behavioral responses to sensory stimuli. Please complete this form if you would like us to contact you to determine if you or your child is eligible to participate in a study as well as answer any questions you may have about participation.
Name of Potential Participant
Your Name
Primary Contact Number
Whose contact information is listed?
Participant
Parent or Primary Caregiver
Home number
Other
Secondary Contact number
Whose contact information is listed?
Participant
Parent or Primary Caregiver
Home number
Other
Primary Contact Email
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