Your contact details

Thank you for your interest in our study on eye-gaze technology.  It is called the Eyes on Communication study.

We ask you to complete a few questions to help us make contact with you.  We will only use this information to make contact with you about this eye-gaze study and not for any other reason.

The questions marked with an asterisk * must be answered before moving to the next question. 

* 1. Your name

* 2. Your child's name

* 3. Your child's date of birth

Date of birth
/
/

* 4. Your contact details

* 5. Your address

T