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UMBC Accessibility Research Screener
Thank you for your interest in our study. We appreciate your help! Please complete the form below to help us schedule the study. If you have any questions about this study, please contact Dr. Shaun Kane at
skane@umbc.edu
.
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* Indicates required question
Your name
*
Your answer
Your age
*
Your answer
Your email
*
Your answer
Your phone number
*
Your answer
Do you use a desktop screen reader? If so, which screen reader do you use?
*
Your answer
Do you use an accessible mobile device or tablet, such as an iPhone, iPad, iPod, or tablet? If so, which device(s) do you use?
*
Your answer
Are you able, with advanced notice, to travel to the NFB Jernigan Institute for a research study? Please note that we can reimburse you for taxi or other fare up to $20.
*
Yes
No
Please indicate which days you are typically available to participate in a research study. The study will take approximately 2 hours.
Monday morning (9-12)
Monday afternoon (12-5)
Monday evening (5-8)
Tuesday morning (9-12)
Tuesday afternoon (12-5)
Tuesday evening (5-8)
Wednesday morning (9-12)
Wednesday afternoon (12-5)
Wednesday evening (5-8)
Thursday morning (9-12)
Thursday afternoon (12-5)
Thursday evening (5-8)
Friday morning (9-12)
Friday afternoon (12-5)
Friday evening (5-8)
Saturday morning (9-12)
Saturday afternoon (12-5)
Sunday morning (9-12)
Sunday afternoon (12-5)
May we retain your contact information to let you know about future studies?
*
Yes
No
Is there anything else that you would like us to know? Please indicate if you have any hearing or motor difficulties which may affect your ability to participate in this study.
Your answer
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