Interest Form

You were contacted because you have been identified as someone who may meet our inclusion criteria. This study is looking at how having a sibling with a disability affects mental health. If you are still interested in participating, please fill out the questions below. If you have questions that you would like answered, please contact us:

Rebecca Abel and Sienna Miley
Email: smiley@gm.slc.edu
Phone: 518-937-7520

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1. What is your first name?

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2. How old are you?

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3. What is your email?

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4. What is your parents email? 

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5. What is a good phone number to reach you at? 

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6. We plan on using email as the main contact method. Does this work for you?

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7. Please select the following that apply to you:

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8. Please describe your sibling's disability.

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9. Do you have a disability?

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10. If yes, please describe. 

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