Academic Non-Commercial Use Request Form – Health-related Family Quality of Life Instrument

Health-related Family Quality of Life Instrument v1.0 is available free of charge to those individuals who have a full-time academic appointment at an academic or other non-profit research institution for non-commercial purposes. You may use and make copies of the copyrighted material for your research. You may not use the copyrighted material for commercial purposes without the written consent from the provider.

Commercial purposes include sale, lease, license, or other transfer of the copyrighted material to a for-profit organization. Commercial purposes shall also include uses of the copyrighted material or modifications by any organization, to perform contract research, to produce or manufacture products for general sale, or to conduct research activities that result in any sale, lease, license, or transfer of the copyrighted material or modifications to a for-profit organization. If you are interested in using the survey for commercial purposes, please submit commercial user enquiry form. Include following citation in any reports or publications using the copyrighted work:

M. Elise Radina, Deonni P. Stolldorf, Vaughn G. Sinclair, Mary S. Dietrich, Melissa A. Adair, Terrah Akard & Sheila Ridner (2023): Development and preliminary validation of a health-related family quality of life instrument, Health Care for Women International, DOI: 10.1080/07399332.2023.2190984

I agree to the terms and conditions

Contact Information

Please provide the following information:

First Name: *

First Name

Last Name: *

Title: *

E-Mail Address: *

Phone Numbers

Primary: *

Secondary:

Organization

Please provide some information regarding the organization requesting...

Organization Name: *

Organization Type : *

Please describe your organization.

Address

Country: *

Address: *

City: *

State: *

Zip / Postal Code: *

Role in Organization: *

Please select your role within the organization.

Student

You've indicated that you are a student. Please provide degree as well as the contact information for your PI.

Please provide your degree (BA, MA, PHD, etc.) and Major.

PI Name: *

Please provide your PI's full name.

PI E-Mail: *

Please provide your PI's e-mail.

Please describe your role within the Organization.

Request Details

Please provide the following details regarding your inquiry so that we may better assist you.

Product Use: *

Please describe the type of projects for which this survey will be used for.

Duration of Use: *

Pleas state the expected duration of the project for which survey will be used

Purpose: *

Please describe the purpose of the project e.g. Title of the research study, duration of study, number of study participants involved, funding source, and geographic location of the study, etc.

How did you hear about the product?: *

Please state where you hear about the about VU Kidney Health Surveys?

Additional questions:

Do you have any additional questions/comments or feedback for the developers of the survey?

CAPTCHA

This question is for testing whether you are a human visitor and to prevent automated spam submissions.

Academic Non-Commercial Use Request Form – Health-related Family Quality of Life Instrument

User login

Who we are


This site, host server, and the content (exc. CC-licensed photos) and software applications contained within are owned and copyright © 2024 Vanderbilt University. All Rights Reserved. Please read our Privacy Policy and our Term of Sales. Ways to Contact Us.