Study Application

Care 4 the Caregivers Study

Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

Phone(Required)

Additional Information(Required)

Child/Children's name(s), age(s), disability(ies).

Availability(Required)

During this study participants will need to spend 2 hours a week in classes for 5 months. What days and time are most preferable for you?

Weekday 12-2

Weekday 6-8pm

Weekend 6-8pm

In-Person(Required)

Would you be able to go to class in-person (downtown Phoenix) during this time?

Yes

Yes- but only if respite was provided

Location

Phoenix

Tucson