Thank your interest in the Middletown post-pandemic study!

Please take a few moments to answer the following questions.

Your answers will help us select participants for the study. Should you qualify, someone with the Middletown Youth Services Bureau (MYSB) will contact you via email over the next 5 - 7 business days to schedule an interview time.

Your answers here won't be shared with anyone outside of the MYSB or the researchers leading this project.

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* Do you go to school, have kids that to go school, teach, or work in Middletown?

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* Please enter your first and last name.

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* Please enter your email address.

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* Please enter your mobile phone number.

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* Are you comfortable having an online 1:1 interview over Zoom?

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* Are you able to find 45 minutes of uninterrupted time, on a weekday, between now - January 31?

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