Twins sign up form

Title of Project: Children with language, reading and communication problems Name of Chief Researcher: Prof Dorothy V M Bishop

Before completing this form, please read the information sheet and view the video that explain about the study. If you are interested in taking part, please complete this form with contact details.
A member of the research team will then get in touch to discuss the project further.

Are your twins identical or non-identical?

Are your twins female or male?

Does either twin have difficulty with reading or language?

Details of person completing this form

Mother
Father
Guardian
Carer

Your name

Your Address

Your telephone number

Your mobile number (optional)

Your E-Mail Address

Please indicate your preferred mode of contact

Mail
Telephone
Mobile
Email

Please indicate the best time to contact you by telephone

Where did you hear about this study?