Intake Submissions

Mississippi and Alabama Adolescent Environmental Health Study
Would you like to know how your environment may be impacting the health of you and your children? If you live in Mississippi, researchers at Brown University School of Public Health will be conducting a research study to better understand how your water, soil, air, and noise quality may be impacting the health of you and your children. You and your child will be eligible for $175 upon completion of your study visit!
Are you interested in enrolling in our study?*

I would like to enroll in your current study assessing the impacts of your environment on your child's/children's health.I have participated in the past and am interested in a follow-up visit.
Name

First NameLast Name
Please fill in your PHYSICAL address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
Which community are you apart of?*
Please provide your email *
example@example.com
When is a good time to reach out to you to schedule a study visit?

Morning (8am -noon)Afternoon (12 pm - 5 pm)Evening (after 5pm)
Once you submit this intake form, a member of our research team will reach out to you within 3 business days. If you do not receive a response from us, check your spam folder or email us at erica_walker@brown.edu.

*This study was approved by Brown University's IRB (study #07).
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Mississippi and Alabama Adolescent Environmental Health Study