ASPO-HNS Survey Application

ASPO-HNS Survey Application
Survey Title
Author/Applicant Name

First NameLast Name
Author/Applicant Email
example@example.com
Institution
Funding Agency and details (if applicable)
Is the applicant an active ASPO-HNS member?
ASPO-HNS Member Sponsor (Required if applicant is not an ASPO-HNS member)
ASPO-HNS Member Sponsor Letter Upload

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Please submit either an electronic link to your survey (i.e., Survey Monkey) or a word document with all questions and any logic/branching.

*An electronic format will be required for distribution but is not requyired at time if application.
Survey Link (electronic)
Survey Questions (word document or PDF)

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Cover/Invitation Letter (request email to be sent to ASPO-HNS membership to complete your survey)

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What are the objectives of the survey?
What do the author(s) expect data collected from this survey to show?
How will the data collected as a result of this survey be used specifically? (i.e., grants, manuscripts, presentations)
How will this survey contribute to the pediatric otolaryngology field and/or literature?
Please provide a brief summary of the proposed statistical analyses to interpret the data collected and a letter of support from the statistical consultant performing these analyses.
Statistical Consultant Letter Upload

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A letter of approval/exemption from the IRB must be sent to the ASPO-HNS Research Committee before the survey can be posted/distributed.

Please upload your approval/exemption letter below, or email to Liz O'Keefe at eokeefe@aspohns.org once received.
IRB Letter Upload

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Questions? Please contact:

Liz O'Keefe, ASPO-HNS Associate Director

eokeefe@aspohns.org

(312)585-7001
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