Australia HPPD Study Recruitment
A University study seeking to understand Hallucinogen Persisting Perception Disorder (HPPD) is scheduled to start early 2021 (pending COVID).

The study will begin in Australia, but may extend to international sites at a later time.

If you have HPPD, reside in Australia, and would be interested in participating in the study, please fill out your contact details below.

Note: The initial phase of this study is only available to subjects in Australia.  If you do not live in Australia, you are welcome to still fill out this form to be considered for later phases of this study.
Sign in to Google to save your progress. Learn more
Email *
Full Name *
Please enter your First and Last name
Age *
What Country do you live in? *
What City & State do you live in? *
Phone number
If there is anything you'd like to tell us, you may do so here.
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms