Request edit access
User Research Participant Recruiting Screener Questionnaire
Office of the CTO at VA
Sign in to Google to save your progress. Learn more
These questions allow us to better match you with specific feedback sessions.  

Questions with * are required. We will only use your address and phone number to coordinate your participation in the study and to provide your compensation. The more information we have, the better we can match you with the most helpful feedback sessions. For the additional questions, please only answer questions you feel comfortable with.

Respondent burden: 5 minutes
OMB Control #: 2900-0770
Expiration date: 2023-11-30
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms