Research Collaborator Membership Form

eviDent Research Collaborators are eviDent DPBRN members who are not eligible to be eviDent Associate or Chief Investigators, but who are closely involved with different aspects of eviDent projects. 

Member eligibility

To maintain your membership as an eviDent Research Collaborator, you must work with and be supervised by an eviDent Chief or Associate Investigator when participating in an eviDent project. As an eviDent Research Collaborator you will have an interest in research and strong administrative and organisational skills.

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 organisations 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 eviDent 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 opportunities
• Opportunity to suggest and develop research projects

Register your interest below.

Please complete all required fields!

1. Personal Information
2. Title*
   DrA/ProfProfMrMsOther (please specify)Please make a selection
3. Other*
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4. Full Name*
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5. Position*
   Please SelectPractice ManagerDental AssistantDental HygienistDental TherapistOral Health TherapistDental ProsthetistRetiredOther (please specify)Please make a selection
6. Other*
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7. Email Address*
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8. Practice Phone*
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9. Mobile Number
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10. Practice Fax
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11. Practice Address*
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12. Suburb*
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13. State*
    ** Please Select **VictoriaNew South WalesQueenslandAustralian Capital TerritorySouth AustraliaWestern AustraliaNorthern TerritoryTasmaniaPlease make a selection
14. Postcode*
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15. 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.
16. Password*
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17. Verify Password*
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18. Next >

1. Areas of Interest
2. Please describe your research interest / what you would like to research:*
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3. < PrevNext >

1. Declaration
2. I declare that:*
   a. I undertake to comply with eviDent’s policies, directives and all relevant legislation. I understand that failure to do so could lead to the possibility of termination of membership from eviDent;Please tick the boxes.
3. I declare that:*
   b. I will work with and be supervised by an eviDent Chief or Associate Investigator when participating in an eviDent projectPlease tick the box
4. I declare that:*
   c. (Where applicable) I have the permission of the practice owner(s) to conduct research within my place of work for the purpose of eviDent projects.Please tick the box
5. < PrevSend Application
6. *
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