Patient Evaluation of Research Study Staff

Thank you for participating in a clinical research study. Please take a few minutes to complete this questionnaire
to let us know what we are doing right and how we can improve the experience in the future.

First Study Visit
NA 5 4 3 2 1
I understood all study procedures before signing the informed consent
Research staff took the necessary amount of time to answer all my questions
I understood and felt as though I could withdraw from the study at anytime
I understood the risks and benefits involved with participating in the study
I received adequate information (map, directions, etc.) to find the clinic
Office Operations
5 4 3 2 1
My research visits went smoothly
I was able to schedule my appointments at a time that worked for me
I did not have to wait long for study procedures or to meet with staff
Facilities were clean
Parking was not a problem
Research Stuff
5 4 3 2 1
The research staff was professional and courteous
The research staff was approachable when I had questions or concerns
The main study doctor was available and involved with my care
The staff was knowledgeable and proficient (including blood draws)
I felt comfortable discussing my personal health with staff
I would describe my experience with the following clinic staff as positive
Name(s) of research staff
Name of study doctor
Overall Experience
Yes No
I would participate in another research study at this clinic
I was adequately compensated for my participation in the study
I would like to be contacted for future studies
Having research available at this clinic makes me more inclined to establish care here
Any suggestions for improvement or additional feedback would be appreciated.
Your name (optional)
Date of your visit




Your feedback is vital to the success of our research. Please fill in the form fields below.