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Patient Feedback Survey For Clinical Research

Patient Feedback Survey For Clinical Research

This field is for validation purposes and should be left unchanged.

** DEMOGRAPHIC INFORMATION (OPTIONAL)

GENDER

SITE STAFF REVIEW

How would you rate the communication skills of the staff?
Were the study team members clear in their explanations?
Were you provided with sufficient information to make an informed decision about participating?(Required)
Were the study team members receptive to your needs and concerns?

SITE REVIEW

Did you face any issues with transportation for your visits?
Was the facility clean and comfortable?
Was the facility and location of the clinical trial site easily accessible to you?
How would you rate the facility at our site?

GENERAL EXPERIENCE

Did you feel adequately supported throughout your visits?
How would you rate your overall experience?
Would you like to enroll in another clinical trial in the future?
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Revive Research Institute, Inc.

28270 Franklin Road
Southfield, MI
48034

T: 248-564-1485
E: info@rev-research.com