UCLA CART Research Participation Form

The UCLA Center for Autism Research and Treatment (CART) conducts many types of research studies for individuals with autism spectrum disorders (ASD). Please complete this form if you would like a UCLA CART staff member to contact you to determine if your child is eligible to participate in a study. Your answers are confidential. If you have any questions about this form or our studies, please call UCLA CART at (310) 825-9041. If you have any questions about your rights as a research participant, please call the UCLA Office for Protection of Research Subjects at (310) 825-8714.

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Age child started walking
Age child first used meaningful words?
Age child first used simple phrases?
Please list everyone who lives in your household (include yourself)

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Individual 2:
Individual 3:
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