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M-HELP Contact Form - Women and Partners (Online survey)
Thank you for your interest in participating in this research study. If you provide your contact details below, a member of the research team will contact you as soon as possible.
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Name: *
Please indicate whether you are a woman who has just experienced early pregnancy loss, or the partner of a woman who has just experienced early pregnancy loss. *
Email address
Telephone number:
Preferred contact method: *
Required
If you have a preference for how or when you would like to be contacted, please provide further information here (e.g. preferred days or times).
If you have any questions at this point, feel free to provide those below, and we will be sure to address them. You are of course also free to ask any questions when you are contacted by the research team.
Again, we are sorry for your loss, and we very much appreciate your participation in this study. On the basis of your input, we aim to improve the emotional care provided to women and partners who experience early pregnancy loss in the future.
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