The first step to acquiring limited access to use the JHFRAT is to complete this brief enrollment form. Will you be using the JHFRAT for a school project or a research study? * School project Research study First Name * Last Name * School Information Name of School * Name of Organization/Facility (i.e., hospital) where Tool will be used * Title of Your Project * Purpose of the project * Describe how the JHFRAT will be used in your project. Time Frame (school semester or anticipated number of months used) * JHFRAT_Terms and Conditions_Student 7-24.pdf I accept the Terms and Conditions above * Yes Do you agree to send a final copy of your project or study to IJHM@JHMI.EDU * As per the terms and conditions above this is required to be granted access to use the JHFRAT in your study/project. Yes Study Information Name of the Study * Purpose of the study * List off all locations where the JHFRAT will be used for the study * Is this research funded? * Yes No JHFRAT_Terms and Conditions_Study for Licensed Practitioner 10-24.docx I accept the Terms and Conditions above * As per the terms and conditions you are required to share the final results of your project or study with us. Send to ijhn@jhmi.edu. Yes Do you agree to send a final copy of your project or study to IJHM@JHMI.EDU * Yes Leave this field blank What code is in the image? * Enter the characters shown in the image.
