If you would like to claim your $10 gift card for participating in the CRISM Emergency Department Physician Survey, please fill out the form below.

Entering your information on this form is completely optional and will not affect your participation in the survey. Please note that we require only your email, so that we can contact you with information about claiming the gift card, and your primary hospital affiliation (where you heard about this survey) for recruitment tracking purposes – please write this in the main message box of the form. You may choose to only provide your first name if you wish.

Alternatively, if your site has informed you of an alternative compensation program, such as a raffle, in which you are choosing to participate in lieu of the gift card, please write this in the main message box below along with your primary hospital affiliation (where you heard about this survey). You may be contacted by your site lead about joining the raffle.

The information collected in this form will not be linked to your survey responses, which are anonymous, and will not be used in any other way except to contact you with information about compensating you for your time spent participating in this study.

A CRISM representative will respond to the email provided shortly with information on how to claim the gift card. If you have not received payment within one week of completing the survey, please email kelsey.vanpelt@bccsu.ubc.ca or contact your local study lead.

Thank you!

Please enter your email and primary hospital affiliation below