HIV Disability Questionnaire (HDQ) - Research & Innovation

Interested in the HIV Disability Questionnaire (HDQ)?

Please complete this form to access the HDQ.

McMaster University and University of Toronto are providing you a non-exclusive, royalty–free license to use the HIV Disability Questionnaire (HDQ) for research, academic, and non-commercial purposes only. Any other use requires written permission from the rights holder. In addition to the foregoing, any time you use and share the HDQ you must provide attribution to the authors and the owners. The following acknowledgement should be used: “© 2017; Kelly O’Brien. Patty Solomon, Ahmed Bayoumi, McMaster University; University of Toronto. All rights reserved.”

You are prohibited from modifying, adapting, translating or making derivative works of the HDQ. If you are interested in translating the HDQ this will require permission, please contact the author Dr. Kelly O’Brien at kelly.obrien@utoronto.ca and provide details below in “Additional Comments”.

The HDQ is provided “as is” and without any warranty of any kind, either express or implied. McMaster University, University of Toronto and the HDQ disclaim responsibility for any errors or omissions or for results obtained from the use of information contained herein.

First Name *

Last Name *

Title / Position *

Email *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Institution / Organization Name *

Phone *

Proposed Use of the HDQ *

Title of Study *

Who is Funding / Sponsoring the Study? *

Name(s) of Principal Investigator(s) *

Year of Study *

Version Requested (check all that apply) *

Original (North American English)

How will the HDQ be Administered? *

Hard copy
Electronically

If electronically administered, please indicate specific mode of administration

What is the target population proposed to administer the HDQ? (e.g. description of characteristics of study participants) *

Number of study particpants to be administered by the HDQ

Additional Comments