phinder intervention identification form
If you have an intervention that you would like to be displayed on phinder please complete as many sections of the form as you can. The information that you provide will be displayed on the intervention page of the website. Once it is on the web site, researchers will be encouraged to make contact with you for an initial informal conversation about the potential for working with you to co-produce relevant research.
Name *
Your answer
Position *
Your answer
Organisation *
Your answer
Contact email address *
Your answer
Email to be displayed on the website *
Your answer
Tell us about your intervention
This could include:

• who the intervention is for
• what the intervention aims to achieve
• what the intervention involves (procedures, materials, personnel)
• who is paying for the intervention, and how much
• the timescale for implementation

Intervention details *
Your answer
Has any research been conducted to date?
(e.g. needs assessments, pilot or feasibility studies)
Your answer
Web address for more intervention detail
Your answer
What do you think is the main research need? *
Your answer
Data protection
The National Institute for Health Research (NIHR) takes your privacy seriously. We will only use the personal information collected on this form to publish on phinder and to communicate with you about phinder. Your information will be held for the life course of phinder and will be held securely. We do not pass on your details to any other person or organisation. You have a number of rights with regard to the data we hold about you, including the right to request the data we hold about you, to have it removed or corrected. To find out more about data protection please see the NIHR privacy policy: https://www.nihr.ac.uk/about-us/documents/NIHRPrivacyPolicyMaster_v1.0_20161024.pdf

By ticking the below box I consent to NIHR holding and publishing my name and email addressed on www.phinder.ning.com. I understand that I may be contacted by parties interested in developing a research application in response to this information being published. I also understand that phinder is hosted by Ning, Interactive Inc. in a 3rd country, and am aware of its privacy policy https://www.ning.com/privacy/.

*
Required
Submit
Never submit passwords through Google Forms.
This form was created inside of National Institute for Health Research. Report Abuse - Terms of Service