DIGA Research Dissemination Application Form
IMPORTANT-PLEASE READ FIRST!

Over the last few months, we have received multiple requests from students and faculty for help disseminating surveys for research. At the time, we felt this was not within the scope of our organization, serving as a centralized platform of resources and information for dermatology-interested medical students to pursue their academic and career goals. As the requests have grown, we have decided to trial a method for students to share their projects through our list in a open manner. To help ensure fairness and not spam our list, we have implemented the following rules that we ask you follow.

- This form is for dissemination of survey-based research to our mailing list.
- We distribute surveys once a month as to not overload our list, no exceptions please.
- Projects should be targeting or investigating academic dermatology or medical education topics. Please think carefully about if this is the best way to disseminate your survey and if this is the target audience.
- As this is intended to be a resource for all dermatology-interested medical students, please limit your surveys to 1 project per advisor per 3 months, so that others will have a chance to submit their surveys. Please use your .edu email to submit this form! Non .edu emails will be rejected.
- If you use the list to submit surveys, it is heavily encouraged that you also take the surveys you receive from the
  list!
- We cannot give specifics on the makeup or demographics of our list.
- Please ensure your survey can be done within a 5 minute time period.
- Please do not use this form for solicitations, recruitments, fundraising, etc. Our publicizing form can be found here: https://forms.gle/fvgYcG6EtxhtNLFU9
- Please have your survey ready to take in a link. We cannot upload surveys, attach them to emails, etc.
- We retain the right to reject a submission if it is outside the scope/unfitting for our medical student subscribers, or to shut down submissions/change the form of submissions.
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Email *
Your Name: *
What is your year? *
What is the institution you are affiliated with for this survey? *
What is the title of this project? Please give a short description (target audience, subject) *
If there is an attending/supervising physician for this project, please list their name/title here. *
Below write a SHORT blurb about your project that will be sent out with the link: *
What is the deadline by which your survey should be completed? *
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Please paste your survey link here. *
Overall, how would you would you feel about sending out surveys to this mailing list versus moving them to an opt-in, survey only mailing list? *
Please affirm you have read and agree to follow the rules stated at the beginning of this google form. *
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