PUPStudy Contact Form

Pressure Ulcer Prevention at Home Study

If you are interested in finding out more about the study, please complete this form and a researcher will be in touch with you. Please feel free to pass on the details of this web link to any carers or Personal Assistants you may be in contact with, who you think may be interested.

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Please tick all the boxes:

I am happy for a member of the research team to contact me directly by email or telephone to explain more about the study and to ask if I would like to be involved *

• Yes
• No

Were you told about this research by a clinical professional (at hospital)? *

• Yes
• No

Please indicate which elements of the research you are interested in (you can tick more than one): *

• Be interviewed about your experiences and insights
• Provide information using an app on your smartphone
• Provide information using an app on your smartphone
• Not sure, please contact me to explain more

Name *

First name and first letter of surname

Email address *

Email

Confirm Email

Preferred Telephone contact Number *

Preferred contact time (time of day)

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