If you wish to have your details removed from our database, please contact email@example.com or 03 9479 3271.
If you are a parent registering your child, please provide your child's details here.
First Name (Required):
Last Name (Required):
Date of Birth (Required):
Diagnosis - Please tick all applicable (Required):
You can select one or both of the options below:
I would like to register for the OTARC Research Participant Registry. I understand that my details will be included in the Registry and passed on to relevant researchers.
I would like to register for the following research studies. I understand that my details will be passed on to relevant researchers. (Enter the study code(s) for each study you are interested in, separated by a comma. Our current studies are listed below):
City / suburb (Required):
Post code (Required):
I am registering myself. I am over 18 years of age.
I am the legal parent, guardian or carer of:
(Please provide your name)
Guardian Given Name:
Guardian Family Name:
I would like to receive further information from the Olga Tennison Autism Research Centre
(e.g., quarterly e-Newsletter, Autism news alerts, news and information on upcoming seminars and workshops)
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