Age:

{{ error }}

Gender: * Gender Male Female Non-binary Prefer not to say

{{ error }}

Where are you located? *

US

Canada

Other

{{ error }}

ZIP Code or Postal Code *

{{ error }}

What type of trial, or medical condition, did you sign up for?

{{ error }}

How many trials have you participated in?

{{ error }}

Which racial or ethnic group(s) do you identify with? *
Please select all that apply.
Capturing information on ethnic backgrounds allows us to better understand how different groups may have different needs.

American Indian or Alaskan Native

Asian

Black or African American

Hispanic Latino or Spanish

Middle Eastern or North African

Native Hawaiian or Other Pacific Islander

White

Mediterranean (Greek/Italian/Portuguese/Spanish/etc)

Another race or ethnicity

I prefer not to answer

{{ error }}

Has your doctor ever spoken with you about clinical trials you could participate in? *

Yes No

{{ error }}

Did you consider a clinical trial before you saw the digital advertisement? *

Yes No

{{ error }}

Was this trial for yourself/a child/someone in your care? *
Select all that apply.

Myself

My child/child in my care

Someone else in my care

I do not remember

{{ error }}

What would make you want to participate in a clinical trial in general? *
Select all that apply.

Access to a new treatment

Contributing to medical research

Access to a healthcare provider

Potential health benefit to myself

Financial compensation

Medical costs being covered

Other

{{ error }}

Please specify *

{{ error }}

What type of digital advertisement did you respond to? *

Social media ad (e.g. Facebook Instagram)

Search engine ad (e.g. Google)

Banner ad on websites

Email advertisement

Other

{{ error }}

What made you want to learn more about the clinical trial based on the advertisement that you saw? *

Access to a new treatment

Contributing to medical research

Access to a healthcare provider

Potential health benefit to myself

Financial compensation

Medical costs being covered

Other

{{ error }}

What other places do you go to find information about clinical trials? *

My doctor

My pharmacist

Word of mouth

Online search

Social media

Other

{{ error }}

After signing up online, did you visit a study site for the clinical trial? *

Yes No

{{ error }}

Why? *

{{ error }}

Would you change anything about the study site or the study visits to improve your experience?

Yes No

{{ error }}

What would you change?

{{ error }}

Were you able to participate in the clinical trial? *

Yes No

{{ error }}

How would you rate your overall experience with the clinical trial so far? *

Very positive

Positive

Neutral

Negative

Very negative

{{ error }}

What is the reason for your selection above? *

{{ error }}

Did you complete all the visits? *

Yes No

{{ error }}

Why did you decide to end your participation? *
Select all that apply.

Site staff told me I didn’t qualify / wasn’t a good candidate

Study requirements were too demanding (i.e. too many visits - too many tests etc.)

Site was too far from my home

Other

{{ error }}

What is furthest stage in the trial that you completed? *

Signed up online but did not qualify

Answered questions over the phone but did not visit the site

Signed a consent form at the site

I participated in the trial (also known as enrolled)

{{ error }}

Would you consider signing up for a clinical trial again? *

Yes No

{{ error }}

Would you sign up for a clinical trial through an online advertisement again? *

Yes No

{{ error }}

What suggestions do you have for improving online recruitment for clinical trials? *

{{ error }}