DNCLab participation registration form, Developmental Neuromotor and Cognition Lab , La Trobe University

First Name *

Last Name *

Email *

Gender

Male
Female
Other
Prefer not to say

Diagnosis - Please tick all applicable *

No disabillity
Autism Spectrum Disorder
ADHD
Williams syndrome
Down syndrome
Fragile X syndrome
Other disability (please specify below)

Diagnosis - Other (please specify)

Research participation * Select one or more of the options listed. (I understand that my details will be included in the registry and passed on to relevant researchers)

I would like to register for the DNCLab Research Participant Registry.

I would like to register for the following research studies: You can select one or more of the options below.

Multitasking effects on motor control in childhood through adolescence**
Attentional demands on motor control across genetic developmental disorders #
A neurobiological comparison of the effects of oxytocin on inflexibility, fear and anxiety across typical and atypical development ##

Address *

Suburb *

City *

Post Code *

Country

Telephone

Mobile *

Declaration *

I am registering myself. I am over 18 years of age.

I am the legal parent, guardian or carer of:

A child with a genetic disorder, ASD and/or other disabilities
A child without disabilities
A person aged 18 years or older with an ASD and/or other disability

Guardian Given Name:

Guardian Family Name

More information

I would like to receive further information from the DNCLab about upcoming events and studies being conducted by our researchers

** (Required participants: Families of children (7-17 years) who are typically developing and without a disability). Study ID MTD01
# (Required participants: children, adolescents and adults diagnosed with Williams syndrome or Down syndrome (aged 7-17 years, 18+) and parents/guardians. Study ID Code: MTAT2
## (Required participants: adolescents and adults diagnosed with Williams syndrome (aged 15-35 years) and typically developing adults (aged 18-35 years). Study ID Code: OXT03

Privacy statement

La Trobe University respects the privacy of your personal information. The DNCLab collects personal information about you to register your participation. For this purpose, we will use this information and typically disclose it to relevant researchers. If your personal information is not provided to us then we cannot validate your participation. You may have the right to access the personal information we hold about you subject to any exemptions in relevant laws, by contacting us.