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Country No Country selected Canada United States Afghanistan Albania Algeria Andorra Angola Anguilla Antigua And Barbuda Argentina Armenia Aruba Ashmore And Cartier Islands Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Bassas Da India Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia And Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burma Burundi Cote d'Ivoire Cambodia Cameroon Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Clipperton Island Cocos (Keeling) Islands Colombia Comoros Congo Congo (Demo. Republic) Cook Islands Coral Sea Islands Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Europa Island Falkland Islands (Islas Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern/Antarctic Lands Gabon Gambia Gaza Strip Georgia Germany Ghana Gibraltar Glorioso Islands Greece Greenland Grenada Guadeloupe Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island/McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle Of Man Israel Italy Jamaica Jan Mayen Japan Jersey Jordan Juan De Nova Island Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue No Man's Land Norfolk Island North Korea Norway Oceans Oman Pakistan Palau Panama Papua New Guinea Paracel Islands Paraguay Peru Philippines Pitcairn Islands Poland Portugal Qatar Reunion Romania Russia Rwanda Saint Helena Saint Kitts And Nevis Saint Lucia Saint Pierre And Miquelon Saint Vincent And The Grenadines Samoa San Marino Sao Tome And Principe Saudi Arabia Senegal Serbia And Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia/Sandwich Islands South Korea Spain Spratly Islands Sri Lanka Sudan Suriname Svalbard Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad And Tobago Tromelin Island Tunisia Turkey Turkmenistan Turks And Caicos Islands Tuvalu Uganda Ukraine Undersea Features United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Wallis And Futuna West Bank Western Sahara Yemen Zambia Zimbabwe

Postal/Zip Code

Phone

Fax

Personal Website Link

Organization

Job Title

Qualifications

Affiliations

I am comfortable speaking in: English
French

I am comfortable reading in: English
French

I am comfortable writing in: English
French

Which of the following categories best describes your research? basic science research
clinical research
health services, systems, and policy
population health

How would you describe yourself? academic researcher
administrator
clinician
educator
policy advisor or analyst
research staff
student
other:

Which statement best describes your previous experience with respect to CAM research? I have participated in a variety of CAM research projects
I have participated in at least one CAM research project
I have never participated in a CAM project, but I am very interested in participating in CAM research in the future
I have never participated in a CAM research project, but I am interested in keeping in touch with research in this area

From the following list, please identify at most FOUR areas which best describe your specific research interests. Please note the options have been grouped into four main categories. Your 4 choices may be in different categories, or all in the same general category.

CAM Therapies

CAM therapies in general
Natural Health Products in general
Acupuncture
Aromatherapy
Botanical/Herbal Medicine
Chiropractic
Diet and Nutrition
Homeopathic Medicine
Massage therapy
Mind-Body Therapies
Naturopathic Medicine
Orthomolecular Medicine
Osteopathic Medicine
Therapeutic Touch
Traditional Chinese Medicine
Energy Therapies
Spiritual Approaches
Other:

(Medical) Condition Classifications

Cardiovascular disorders
Chronic illness in general
Dental and oral disorders
Dermatological disorders
Ear, nose and throat disorders
Endocrine and metabolic disorders
Gastrointestinal disorders
Genitourinary disorders
Hepatic and biliary disorders
Immunological disorders
Musculoskeletal disorders
Neurological disorders
Nutritional disorders
Obstetric/gynecological disorders
Oncological/hematological disorders
Ophthalmologic disorders
Pediatric disorders
Psychiatric disorders
Pulmonary disorders
Other:

Populations

Men
Women
Pediatric
Geriatric
Pregnant
Ethnic Groups
Other:

Health Services Research

Health law and ethics research
Health policy research
Health promotion/wellness/disease prevention
Integration of CAM and conventional care
Patient-practitioner relationships
Regulation of CAM products and practices
Other:

Have you ever been funded by CIHR for a CAM research project as a:
(check all that apply) Principal Investigator
Co-investigator

Have you ever been funded by SSHRC for a CAM research project as a:
(check all that apply) Principal Investigator
Co-investigator

Have you ever been funded by NSERC for a CAM research project as a:
(check all that apply) Principal Investigator
Co-investigator

Have you ever been funded for a CAM research project by a funding agency at the:
(check all that apply) National level
Provincial level
Local level

We would like to know about some of the research you have been involved in. Please describe (up to a maximum of 5) the most important research projects you have been involved in over the past 5 years - past, current, or ongoing.

Title	Start Year	End Year	Ongoing	Study Design / Research Method
			Yes No
			Yes No
			Yes No
			Yes No
			Yes No

How did you hear about PedCAM? I was referred by an outside organization (e.g., research network, professional association, college or university, government organization). Which organization?
I was referred by an individual colleague or heard about PedCAM through word of mouth.
I heard about PedCAM while attending a conference or participating in a course or seminar. Which conference, course or seminar?
I received an email from PedCAM inviting me to join.
I found PedCAM while performing an Internet search.
Other: