ANZICS CTG Surveys

Name *

First

Last

Email *

Institution *

Full study title *

Short study title

Chief Investigators - Please list all members and their affiliated institutions *

Target ANZICS CTG Participants (select all that apply)

If other, please specify

Survey Link

Closing Date

Date for distribution

Would you like this EOI/survey shared on social media?

Specific date

Survey reminders (Reminders are only sent for ANZICS CTG endorsed or supported studies)

Summary of email to be circulated (upload)

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Protocol Upload

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Survey Upload

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Ethics Approval

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Date / Time

Date

Time

ANZICS CTG SURVEY & EOI Distribution Requests