Current access : Public
User ID :
Password :
Password reminder
Subscribe
 
   
10 questions   5 questions   Validation

Note: Please note that the completion of this form is required to obtain the ADAPTE Manual

1. How did you learn about ADAPTE?
ADAPTE Website
Another Website
Peer-reviewed literature
Conference
Colleagues
Other
2. What is your interest in the ADAPTE process?
Exploring for possible use
For guideline development
For guideline implementation
Planning to use the ADAPTE process
For guideline development
For guideline implementation
General interest only
Personal interest only
Research interest only
3. Contact details
Contact person(s)
Primary contact
Alternate contact
Role of primary contact in guideline development team (Please tick all that apply)
Medical specialist
General practitioner (Family doctor)
Epidemiologist / Public health physician
Pharmacist
Nurse
Professionals allied to medicine (e.g., occupational / physio / therapist)
Methodologist
Health services research expert
Non medical staff e.g. administrators, policy-makers
Other
Name of interested organisation / group if relevant
Address
Country
Telephone number
Primary
Alternate
E-mail address
Primary
Check primary
Alternate
Check alternate
Website address, if applicable
4. Organisation/Group Description
4.1. How would you describe your organisation/group? (Please tick all that apply)
Government agency
Ministry
Academic / research institution
Private not for profit organisation
Health care institution, hospital, network
Professional association / agency
Pharmaceutical / Device / Medical industry
Other
4.2. What is the coverage/authority of your organisation/group? (Please tick all that apply)
Local / regional
Provincial / state
National
International
5. Guideline development and/or adaptation experience
5.1. Please indicate what, if any, experience your organisation has with guideline development, implementation and adaptation below. (Please tick all that apply)
Guideline development
Adapting from existing guidelines
Guideline implementation
Guideline evaluation or monitoring
None of these
5.2. How many guidelines did your organisation produce during the last 5 years?
0
1-5
6-10
>10
6. I am/ we are interested in participating in the evaluation process of ADAPTE.
Yes
No
Unsure

According to modified French Law on Informatics, Files and Liberties 78-17 of January 6th, 1978, this website has been declared to the Commission Nationale de l’Informatique et des Libertés (CNIL).
Registrations and gathering of data are in agreement with the rules edited by the CNIL. Data provided by users will not be used commercially but solely by the ADAPTE Collaboration within its evaluation study.

You may access and modify your data by sending an Email to contact@adapte.org
Sitemap © Copyright Adapte 2007 Created by : VRDCI