Expecting Families Form

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Dear Expecting Parent or Guardian,

Thank you for your interest in the BEST Study! This study will help people understand how families with young children in Tulsa are doing. People in Tulsa will use the results to make services for children better.

By completing this form, you are expressing interest in the study following the birth of your child. Should you consent, we will maintain your information and contact you after the due date that is listed.

If you have questions or concerns about the BEST Study, please contact one of the study leaders from the American Institutes for Research (AIR): Eboni Howard, 312-588-7339, ehoward@air.org, or Patricia Garcia-Arena, pgarcia-arena@air.org. If you have concerns or questions about your or your child’s rights as participants, please contact AIR’s Institutional Review Board (IRB). Members of this group are responsible for the protection of project participants. You can reach them at IRB@air.org or toll-free at 1-800-634-0797.

The BEST Study team includes staff from AIR (www.air.org) and Decision Information Resources, Inc. (http://www.dir-online.com/). You can learn more about the BEST Study at https://best.airprojects.org/

Your LEGAL name:*

First NameMiddle NameLast NameSuffix

Your relationship to child:*

Please specify

Language Test

Anticipated due date*

When are you due?

Your Email*

example@example.com

Your Phone Number:*

Please enter a valid phone number.

Can we text you at the phone numbers listed above?*

YesNo

Preferred method of communication (Please check one)*

EmailTextPhone Call

Do we have permission to reach out to you 1-month after your due date?*

YesNo

Please select your preferred language:*

EnglishSpanish

How did you hear about this study? (Please check all that apply)

Please sign this:*

Today's Date*

Birth Through Eight Strategy for Tulsa (BEST) Study