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UGA's Developmental Research Group's Family Information Survey
Thank you for your interest in our research at UGA (including the PLAY Project, and other studies). Please complete this form
once for each child
so we can provide you with information about our research and contact you when your child is at th
e perfect age for one of our studies. If you have any questions about this form please contact either Dr. Drew Abney (drew.abney@uga.edu) or Dr. Janet Frick (jfrick@uga.edu).
The Developmental Research Group is a group of researchers at the University of Georgia studying infant and child development. Click
here
for our website.
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Parent Name
Your answer
Parent Phone Number (xxx-xxx-xxxx)
Your answer
Parent Address (Street, City, State, Zip)
Your answer
Parent Email Address
Your answer
Youngest Child's Name
Your answer
Youngest Child's date of birth
MM
/
DD
/
YYYY
Youngest Child's due date
MM
/
DD
/
YYYY
Other children (name & date of birth)
Your answer
Languages spoken at home
English
Spanish
Other:
Preferred Contact
Phone Call
Text Message
Email
Where did you hear from us?
*
Your answer
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