Name
Affiliation
Phone
Email
Postal address
Zip
City
Country
Title of the study
Objectives of the study
Study design
RCT
Observational
Survey
Other
Type of the study
Academic or non-commercial
Commercial or commercially oriented
Other
Number of observations / patients
Language version(s) requested
What other generic HRQoL instruments are you going to use?
What disease-specific outcome measure you going to use?
Can this information be disclosed to other / potential 15D users?
Yes
No
What is nineteen plus twelve? (antispam)
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