Online Survey Software | Qualtrics Survey Solutions

Hello and welcome!

This survey is to capture your interest in the (currently named) antiracism implementation science group. We are an evolving group, and will continue to update things. All of the data collected in our surveys is anonymous and available in the link below. This survey is to add your name to our master list for communications regarding our next meetings and surveys.

https://docs.google.com/document/d/1j1U14O0161pLflvDKIFdb9ipiGFVhRfSqeBLdfLN9Iw/edit?usp=sharing

Please share your information:

First name

Last name

Email 1

Email 2

What is your current role?

How do you identify as (select all that apply):

How did you hear about us?

Thank you for your interest. We are always open for feedback, please let us know your thoughts below. Your name and email will be added to our list.