Associate Investigator Membership Form

Associate Investigators are eviDent DPBRN members who are registered and practising oral health practitioners and have ‘intellectual input into the research and whose participation warrants inclusion of their name on publications'.

Member eligibility

eviDent accepts Associate Investigator applications from all registered oral health practitioners working in a private practice, community health or other setting.

All Associate Investigators will be required to complete eviDent’s minimum training requirements before participating in a research project.

Before completing this form, please consider the impact your membership and participation in a research project might have on your practice.

Membership details

  • Membership is free
  • Confidentiality will be maintained as your details will be kept only on our database and will not be distributed to other organizations without your permission

Benefits

  • Opportunity for involvement at all stages of the research process
  • Ongoing access to research training and expertise as well as other development opportunities
  • Regular eNews and invitations to attend networking events
  • Access to a ‘members’ only’ section of the DPBRN website
  • Education of the wider oral health profession through seminars, workshops and conference presentations
  • Establishment of interdisciplinary networks for projects that address the relationship between oral and general health e.g. diabetic patient needs
  • Opportunity to bring research findings into effect more rapidly
  • Opportunity to influence policy
  • Continuing professional development credit via initial training, study group participation, publication of research articles, presentations (lecture/posters) of research, peer-review activities, etc
  • Opportunity to suggest and develop research projects relevant to your daily practice

Register your interest below.

  1. Personal Information

  2. Title*
    Please make a selection
  3. Other*
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  4. Full Name*
    Please enter your full name
  5. Practice Phone*
    Please enter your phone number
  6. Mobile Number
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  7. Practice Fax
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  8. Email Address*
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  9. Practice Address*
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  10. Suburb*
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  11. State*
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  12. Postcode*
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  13. Password

    Enter a password to use when your membership is approved.

    You will use your email address and this password to access the members area.

  14. Password*
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  15. Verify Password*
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  1. Research Information

    To help us build a picture of our members’ research experience, please complete the following:

  2. Qualifications

  3. Name of Course / Degree / Traiing / Fellowship
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  4. Educational Institution & Country
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  5. Year awarded
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  6. Standard abbreviation
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  7. Name of Course / Degree / Traiing / Fellowship
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  8. Educational Institution & Country
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  9. Year awarded
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  10. Standard abbreviation
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  11. Name of Course / Degree / Traiing / Fellowship
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  12. Educational Institution & Country
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  13. Year awarded
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  14. Standard abbreviation
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  15. Name of Course / Degree / Traiing / Fellowship
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  16. Educational Institution & Country
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  17. Year awarded
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  18. Standard abbreviation
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  1. Research Experience

  2. Have you ever presented a research talk?*
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  3. Have you ever attended a research conference?*
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  4. Have you ever written a journal research paper?*
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  5. Have you ever presented a research talk?developed a research poster?*
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  6. Have you ever participated in a peer review project?*
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  7. Please describe:*
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  1. Grant Applications

  2. Have you been a named investigator on a research grant application? *
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  3. Please describe:*
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  4. Areas of Interest

  5. Please describe your research interest/ what you would like to research:*
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  6. Research Projects

  7. How many research projects have you been involved in during the last two (2) years (if any)?
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  1. Permission

  2. I hereby grant permission to the eviDent DPBRN to publish my name on a list of network participants on the eviDent website and in other printed material about the network.*
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  3. Declaration

  4. I declare that:*
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  5. I declare that:*
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  6. I declare that:*
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  8. *
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