Better Mental Health for Older People
IPA - Survey - Epidemiological Studies in Latin America

IPA Survey 
IPA's Latin American Initiative
Epidemiological Studies in Latin America

A major project for the Latin American Initiative is development of databases on epidemiological studies and educational programs in the region. Please use the form below to provide information on epidemiological studies in Latin America.

1 Title of study  
    
     
2 General topical area  
    
     
3 Goals of the study  
    
     
4 Type of study  
    
     
5 Geographic scope of study
(specify area, e.g., National study throughout Peru, specific to Lima, etc.)
    
     
6 Start date of study
     
7 Completion date of study
(if study is not completed, please indicate the anticipated completion date)
     
8 Methods and tools required
    
     
9 Information on principal investigator:
  Name
  E-mail
  Affiliation (university, hospital, etc.)
  Address Street
  Address City
  Address State/Province
  Address Zip/Postal Code
  Address Country
  IPA membership number
     
10 Information on additional investigators: ( up to 5 investigators)
  Name
  E-mail
  Affiliation (university, hospital, etc.)
  Address Street
  Address City
  Address State/Province
  Address Zip/Postal Code
  Address Country
  IPA membership number
     
  Name
  E-mail
  Affiliation (university, hospital, etc.)
  Address Street
  Address City
  Address State/Province
  Address Zip/Postal Code
  Address Country
  IPA membership number
     
  Name
  E-mail
  Affiliation (university, hospital, etc.)
  Address Street
  Address City
  Address State/Province
  Address Zip/Postal Code
  Address Country
  IPA membership number
     
  Name
  E-mail
  Affiliation (university, hospital, etc.)
  Address Street
  Address City
  Address State/Province
  Address Zip/Postal Code
  Address Country
  IPA membership number
     
  Name
  E-mail
  Affiliation (university, hospital, etc.)
  Address Street
  Address City
  Address State/Province
  Address Zip/Postal Code
  Address Country
  IPA membership number
     
11 Publications associated with study
    
     
12 Links to website associated with study
    
     
13 Summary statement
    
     
14 Other Notes or Comments
    
     
15 Your Contact Information
  Name
  E-mail
  Telephone Number
  Fax Number
  Address 1
  Address 2
  Address City
  Address State/Province
  Address Zip/Postal Code
  Address Country
     
Ready to Submit Form YESNO
     
   
     

 

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