UnBIASED Recruitment Form
We need your help! To ensure our work is guided by the experiences and needs of those who face hidden bias in healthcare we are partnering closely with patients and doctors.

SHARE YOUR EXPERIENCE THROUGH A 1 HOUR VIRTUAL INTERVIEW

WHAT: We are engaging people who identify as Black, Indigenous, People of Color (BIPOC) and/or as LGBTQ+ for a 1-hour interview about communication barriers with doctors and how technology can help. Participants will complete a brief online survey about their age, gender, race, ethnicity, education, and experience of bias. Participants will receive a $30 VISA cash card by mail after completing the interview.

HOW: The interview will take with a member of the research team by Zoom videoconference. You have the option to call into Zoom by telephone.

TO SCHEDULE AN INTERVIEW: Please provide your first name and email address or telephone number below. A member of the research team will contact you to schedule an interview at a convenient time.

What is your first name?
What is your email address or telephone number?
Submit
Never submit passwords through Google Forms.
This form was created inside of UC San Diego. Report Abuse