Student Autoinjector and Allergy Research Study - Interview Contact Information Form
Thank you for your interest in our Student Autoinjector and Allergy Research Study!

𝐖𝐡𝐨 𝐰𝐞 𝐚𝐫𝐞: We are a team of undergraduate Bioengineering students at the University of California-Riverside that are currently enrolled in a National Science Foundation (NSF)-hosted business survey course through our university.

𝐎𝐮𝐫 𝐠𝐨𝐚𝐥: We aim to better understand the unique challenges that allergy-prone individuals face with the intent of improving future epinephrine autoinjector design. We are 𝐍𝐎𝐓 selling a product or service of any kind.

𝐈𝐧𝐭𝐞𝐫𝐯𝐢𝐞𝐰 𝐝𝐞𝐭𝐚𝐢𝐥𝐬: We are looking to speak with severe allergy-prone individuals or close family members of allergy-prone children. All information obtained during these interviews will be considered as strictly confidential, and answers to interview questions will be stripped of any personally identifying information prior to analysis. Interviews will last approximately 10 minutes, and take place virtually over Zoom. Participation in this study is completely voluntary, and no financial compensation will be provided.

If you are interested in assisting us in expanding our knowledge of anaphylaxis, severe allergies and the effectiveness of current treatment methods, please enter your contact information below and we will be in touch with you shortly to schedule an interview.

Thank you in advance for your participation, we look forward to speaking with you!

Questions about this study may be directed to Jordan Rolsma at jrolsma@engr.ucr.edu.
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Name *
Email *
Phone Number *
Are you prone to severe allergies? *
Are you a parent or close family member of a child that is prone to severe allergies? *
What is your general weekly availability? Please note that times are in Pacific Standard Time (PST) and that all participants will be contacted to schedule a convenient interview time. Interviews will last approximately 10 minutes.
8 AM - 10 AM
10 AM - 12 PM
12 PM - 2 PM
2 PM - 4 PM
4 PM - 6 PM
6 PM - 8 PM
Mondays
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