AAAAI Survey Request Form

The American Academy of Allergy, Asthma & Immunology (AAAAI) provides its individual members and constituent groups (including assemblies, interest sections, committees, subcommittees, workgroups, and task forces) the opportunity to collect data about its members and their practice of allergy/immunology. These surveys are distributed randomly to 20% of AAAAI membership. The data they generate are used for a variety of purposes, including the development of educational programming and as components of research initiatives. If you are conducting a survey to collect data for a work group report, you must submit a work group report intent form to be approved by the Practice, Diagnostics, and Therapeutics (PDT) committee first.

To submit a request to survey AAAAI members please complete this form. All survey requests are subject to the terms of the AAAAI Survey Data Ownership Policy.

Attachment	Size
survey_data_ownership_policy_04.17.14.pdf	99.27 KB

Submitter Name *

Constituency (e.g. AAAAI Committee, Other Organization) *

Submitter Email *

Leadership Institute *

Is this a Leadership Institute project?

Yes

Survey Rationale *

Describe the need to complete this survey project, including the questions you are trying to answer.

Intended Audience *

Identify which AAAAI member categories you intend to survey. Select all that apply.

US Physicians

International Physicians

Allied Health Providers

US Fellows-in-Training

International Fellows-in-Training

Practicing Physicians Only

Practicing and Retired Physicians

Survey Data Distribution *

Indicate how you plan to make use of the data you collect. Select all that apply.

Develop educational programming, including annual meeting session proposals

Write an abstract for submission to the AAAAI Annual Meeting

Write a manuscript for submission to the JACI, JACI: In Practice, JACI: Global or other scientific journal

Write a workgroup report as an official AAAAI document (see below)

Other (Please email pdtreviews@aaaai.org with additional details)

Report Approval

If you intend to use the survey data to publish a workgroup report, position statement, or systematic review as an official AAAAI document, you must submit an intent form to be approved by the AAAAI Practice Diagnostics and Therapeutics (PDT) Committee first. When submitting the intent form to PDT for a survey intended to lead to a work group report, you will be asked to verify that the chair of your committee or other constituency group has approved the project.

Yes, this survey will support a work group report and all necessary approvals have been secured

No, this survey will not support a work group report

Embargo of Survey Data

If you intend to publish the data you collect, you may request an embargo of up to one year in which to do so. During this time the AAAAI will not distribute the data you collect with any other individual or organization. Do you wish to request an embargo of your data to allow for publication?

Yes

Acceptance of Terms *

By clicking "Yes" you agree to the terms of the AAAAI Survey Data Ownership Policy, as attached above. Do you agree to the terms of the policy?

Yes

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