Nothing Special   »   [go: up one dir, main page]

Volunteering For Involvement in Research: Please Return Your Completed Form Via Email To

Download as doc, pdf, or txt
Download as doc, pdf, or txt
You are on page 1of 1

Volunteering for Involvement in Research

One of the key aims of Fifth Sense is the promotion of research into the causes of smell and
taste disorders and the development of better clinical treatments for these. One way that
members can assist in achieving this aim is as a Public and Patient Involvement (PPI)
volunteer. Recruiting appropriate PPI representatives can be a significant headache for the
leaders of research projects, but is viewed as essential by NIHR (the National Institute of
Health Research, an important research funding body) for projects to be approved. By
recruiting PPI volunteers from within the Fifth Sense membership, with a range of clinical
histories of anosmia (and other relevant conditions) we can greatly aid the formulation of
relevant research and its chances of being funded by NIHR. If you would like to help, could
you please provide brief details by completing the form below. We will contact you when
appropriate opportunities for involvement arise.

Name …………………………………………………………………………………………

Email address ………………………………………………………………………………...

My Symptoms (anosmia, etc.) ……………………………………………………………….

Underlying medical condition (if known; e.g. Chronic rhinitis, post viral infection, etc.)

…………………………………………………………………………………………………

…………………………………………………………………………………………………

Previous PPI experience (if any)


…………………………………………………………………………………………………

…………………………………………………………………………………………………

………………………………………………………………………........................................

Types of Involvement I’m interested in (please tick all that apply, or, if completing
electronically, please replace the appropriate box(es) with the letter 'Y'):

- Helping develop research applications (eg. focus groups)........................................□


- Commenting on research applications prior to submission to the funding body.......□
- Review of progress during the research (eg. steering groups)...................................□
- Review of the research outcomes and the proposals for implementation of
recommendations........................................................................................................□
- Publicising the outcomes of the research....................................................................□

Please return your completed form via email to research@fifthsense.org.uk

You might also like