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Participation Contact Form
If you are interested in participating in one of our studies, fill out this form to be contacted as soon as you and your child are eligible for a study.
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Your name
*
Your answer
Phone number
*
Your answer
Email address
Your answer
City of residence
Your answer
Child's name
Your answer
Child's sex
Male
Female
Clear selection
Child's date of birth
*
MM
/
DD
/
YYYY
Child fluent in:
*
English
French
Other:
Required
What percentage of all words heard in her/his life were in English?
Your answer
What percentage of all words heard in her/his life were in French?
Your answer
What percentage of all words heard in her/his life were in another language? Please specify this language.
Your answer
Does your child attend daycare?
Yes
No
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If your child does attend daycare, what language (s) does she/he hear there?
English
French
My child does NOT go to daycare
Other:
Preferred way to be contacted
Email
Phone
Text Message
Preferred time to be contacted
Morning
Afternoon
Evening
Language to be contacted in
English
French
Clear selection
Two other labs at Concordia University also study children’s development and may have upcoming studies in your child’s age range. Would you also like to have these labs contact you about potential studies?
Concordia Infant Research Laboratory
Cognitive and Language Development Lab
Yes
No
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How did your hear about our lab?
Facebook
Our website
Referred by a friend
Physical poster
Community outreach
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Questions or comments
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