PROJECT TITLE

Short Title

20-100 characters long to be used in invitations and social media

Long Title

20-1000 characters long

ORGANISATION DETAILS

Lead/Sponsor Organisation

STUDY CONTACT

Title/Full Name

Organisation

Address

Telephone Number

Email (CI)

All correspondence from the Join Us team will be sent to this email address.

ETHICS APPROVAL

Does your study have ethics approval from a recognised HREC?

Yes

Please note: you may need to raise an ethics amendment to ensure that your research study has approval to recruit participants through a public register. This can be completed while the Join Us team processes your access form.

HREC Committee Name

Approval Number

Join Us only processes study recruitment requests for ethically approved studies. Please return to this form when your study has ethics approval from a recognised HREC.

Study Summary [500 words]

Provide information that will help us find the right match for your study. Include study description, research impact, etc.

What's Involved?

Include information relating to duration (if applicable), location (if applicable), etc.

Will the research team offer participants a gift voucher or other incentive upon completion of the study?

Yes

Include gift voucher value/reimbursement for travel or parking, and other benefits (e.g. blood test results).

Do you have an existing study website, screening survey, or another link where you would like the matched participants to be directed?

Yes

Include brief website description if applicable (e.g. survey link)

DEMOGRAPHIC ELEGIBILITY CRITERIA

Age

Not Applicable

Minimum age

Maximum age

Language spoken at home

Not Applicable

Click and hold Control key to select more than on languange

Other: please state

Country of Birth

Not Applicable

Click and hold Control key to select more than on languange

STUDY RECRUITMENT PERIOD

From

AGREEMENT

By using the study participant recruitment services Join Us provides, you agree to comply with the following:

Participant Reporting: You will report the number of study participants recruited from the Join Us register in a timely manner when contacted by a Join Us team member. You will receive a recruitment feedback survey within 1-3 months following participant matching. Please include a mechanism to ensure you can track participants recruited via Join Us.

Acknowledgment in Reports: You will include the Join Us register as a listed recruitment source in any published reports/papers from your study.

Data Usage: You will use de-identified data in accordance with the requirements of the register as described in the National Statement on Ethical Conduct in Human Research 2023, Element 4: Collection, Use and Management of Data and Information.

Additional notes:
Join Us is unable to monitor participant behaviour following the distribution of email invitations due to ethics and privacy protocols. Once email invitations are distributed, matched participants can contact the research team at their discretion. Join Us is unable to send out follow-up or reminder emails to matched participants as per internal policy.

However, if you are still recruiting in 3 months, please contact us again and we can search our database for new participants who may be eligible for your study.

STUDY MATERIALS

Please upload:

Approval Letter from your HREC
Study protocol
Participant Information Statement and Consent Form
Study logo/ feature image
Study advertising material

Click "Add another response" to upload more files

HOW DID YOU FIND OUT ABOUT US?*

	Include	Exclude
Female
Male
Other

	Include	Exclude
Aboriginal
Torres Strait Islander
Aboriginal and Torres Strait Islander

NSW	ACT
VIC	TAS
SA	WA
QLD	NT

Allergic disease / allergies and intolerances	Anaphylaxis
Food, drug or medicine allergy	Hayfever

AIDS/HIV	Aneamia
Chronic Fatigue Syndrome / Myalgic Encephalomyelites	Eosinophilic disease
Lupus	Multiple Sclerosis (MS)
Overactive thyroid	Underactive thyroid

Disc degeneration	Disc prolapse
Frozen shoulder	Gout
Joint instability	Ligament tear or injury
Meniscus tear or injury	More than one bone fracture
Neurogenic claudication or spinal stenosis	Osteoarthritis
Osteoporosis	Patellar instability
Rheumatoid arthritis	Sciatica or radiculopathy
Tendinitis	Tendinopathy
Vertebral osteoporotic or compression fracture

Brain aneurysm or have you had a clip inserted	Brain injury or trauma
Epilepsy	Headache disorders (e.g. Migraine)
Motor Neurone Disease	Neurological disease / disorder
Parkinsons disease	Previous head injury

BRCA1 gene mutation (genetic mutation for breast and other cancers)	BRCA2 gene mutation (genetic mutation for breast and other cancers)
Bladder cancer	Brain cancer
Breast cancer	Bowel cancer
Cervical cancer or pre-cancer (e.g. CIN, positive HPV test)	Childhood cancers (cancer diagnosed <19 years old)
Colorectal	Familial Adenomatous Polyposis (FAP)
Haematological (lymphoma, leukaemia)	Kidney cancer
Laryngeal cancer	Lung cancer
Oesophageal cancer	Ovarian cancer
Pancreatic cancer	Penile cancer
Prostate cancer	Skin Cancer (melanoma)
Skin cancer (non melanoma)	Stomach cancer (or gastric)
Testicular cancer	Throat cancer
Uterine cancer	Other known genetic risk factor for cancer – specify
Other type of cancer - please specify

Atrial fibrillation / flutter	Cardiac pacemaker
Congenital / inherited heart disease	Coronary artery disease (including angina, coronary artery stenting, coronary bypass surgery)
Heart failure	High cholesterol
Hypertension / high blood pressure	Poor blood circulation in arms and legs (eg. peripheral artery disease)
Stroke or transient ischaemic attack (TIA)	Valvular heart disease

Asthma	Bronchiectasis
Chronic bronchitis or emphysema	Chronic lung disease
Chronic obstructive pulmonary disease (COPD)	Idiopathic pulmonary fibrosis
Interstitial lung disease	Pulmonary arterial hypertension
Pulmonary fibrosis	Rare lung disease

Back pain	Elbow pain
Fibromyalgia	Foot pain
Hand pain	Hip pain
Knee pain	Neck pain
Neuropathic pain (painful diabetic neuropathy, post herpetic neuralgia, trigeminal neuralgia, complex regional pain syndrome)	Pelvis pain
Shoulder pain	Spinal cord stimulators
Wrist pain

Cataracts	Cochlear/stapes implant
Glaucoma	Hearing loss that requires a hearing aid
Inherited blindness	Macular degeneration

Coeliac disease	Colitis
Gastritis	Irritable bowel syndrome
Reflux	Ulcer

Cirrhosis of the liver	Hepatitis A/B/C
Kidney disease	Non-alcoholic fatty liver disease

Anxiety	Addiction to alcohol drugs or medication
Attention deficit disorder (ADD)	Attention deficit / hyperactivity disorder (ADHD)
Alzheimer’s disease	Autism
Bipolar disorder	Claustrophobia
Dementia	Depression
Dissociative disorder	Eating disorder
Mild cognitive impairment	Obsessive compulsive behaviour (OCD)
Personality disorder, e.g. borderline PD	Schizophrenia spectrum or other psychotic disorder
Trauma and stress related disorder e.g. PTSD

Insomnia	Sleep apnoea
Other sleep disorder

Pre-diabetes	Type 1 diabetes
Type 2 diabetes

Chlamydia	Herpes
HPV	Long COVID
Syphilis	Tuberculosis

Acne	Cellulitis
Eczema or dermatitis	Psoriasis
Rosacea	Shingles
Vitiligo

Breastfeeding – ever breastfed / currently breastfeeding	Dysmenorrhea
Endometriosis	Gestational diabetes
High blood pressure in pregnancy e.g. preeclampsia	Pelvic floor conditions
Polycystic ovary syndrome (PCOS)	Post-partum anxiety (PPA)
Post-partum depression (PPD)	Pregnancy – ever been pregnant / currently pregnant
Pregnancy-related back or pelvic pain