Download:
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pdfSTEP-UP Participant Survey
OMB# 0925-0748
Expiration date: 08/31/2023
Page 1 of 33
*Note to NIH Project Clearance Branch/OMB:
Survey logic and branching results in length of
instrument and presumed repeated education
section (up to 10 education degrees can be listed).
Participants will only see questions that apply, so the
survey skips to next relevant section/question.
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Office of Minority Health Research
Coordination (OMHRC) would like to know about STEP-UP participants educational and professional achievements. As
a former STEP-UP program participant, we are asking you to complete this brief questionnaire about your education
and employment history. Your responses will help us assess the outcomes of the STEP-UP program.
Your participation in this questionnaire is completely voluntary and your survey responses will be kept secure to the
extent permitted by law.
Burden Disclosure: Public reporting burden for this collection of information is estimated to average 5 minutes per
response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining
the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor,
and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control
number. Send comments regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974,
Bethesda, MD 20892-7974, ATTN: PRA# 0925-0748. Do not return the completed form to this address.
Protecting your privacy is very important to us. We will keep your survey responses anonymous. Names and other
personal identifiers will not appear in any report and we will not report individual information, such as education and
professional achievements. Groups of records that contain information about an individual and are designed to be
retrieved by the individual’s name or other personal identifier linked to the individual are covered by the Privacy Act
of 1974, as amended (5 U.S.C. Section 552a). All of the information that you share with us will be kept private under
the Privacy Act. All findings from the survey will be presented in aggregate.
NIDDK will retain data collected through this survey long enough to achieve the specified objective for which they
were collected. The data generated from these activities falls under the National Archives and Records
Administration (NARA) General Records Schedule (GRS) 20-item IC 'Electronic Records,' and will be handled per the
requirements of that schedule (http://www.archives.gov/records-mgmt/grs/grs20.html ).
If you have questions about this privacy policy, please e-mail them to NIDDKStepUpEval@niddk.gov.
By selecting "I consent", you are indicating that you
consent to participate in this survey.
05/08/2020 2:11pm
I consent
I do not consent
projectredcap.org
Page 2 of 33
Contact Information
Is this still the best email address to use to
contact you?
Please provide an updated email address.
05/08/2020 2:11pm
Yes
No
__________________________________
projectredcap.org
Page 3 of 33
Education Please provide information on any degrees that you are currently enrolled in or
have completed. If you have taken the survey previously, your answers will show below.
Please update any of the information that has changed.
Degree
Other degree, please describe:
Associate's degree or equivalent
Bachelor's degree or equivalent
Master's degree or equivalent
Doctoral degree or equivalent
Medical degree
Other degree
__________________________________
Associate's degree type
Associate of Science (A.S.)
Associate of Arts (A.A.)
Other
Undecided
Bachelor's degree type
Bachelor of Arts (B.A.)
Bachelor of Science (B.S.)
Bachelor of Science in Nursing (B.S.N.)
Other
Undecided
Master's degree type
Master of Arts (M.A.)
Master of Public Health (M.P.H)
Master of Science (M.S.) in biomedical science
field
Master of Science (M.S.) in another science or
engineering field
Master of Science in Nursing (M.S.N)
Master of Fine Arts (M.F.A)
Master of Business Administration (M.B.A)
Other
Undecided
Doctoral degree type
Doctor of Philosophy (Ph.D.)
Doctor of Science (D.Sc.)
Doctor of Education (E.D.)
Doctor of Veterinary Medicine (D.V.M.)
Juris Doctor (J.D.)
Other
Undecided
Doctoral degree type Ph.D., please describe:
Doctoral degree type D.Sc., please describe:
Medical degree type
05/08/2020 2:11pm
__________________________________
__________________________________
Doctor of Medicine (M.D.)
Doctor of Dentistry (D.D.S)
Doctor of Optometry (O.D.)
Doctor of Pharmacy (Pharm.D.)
Other
Undecided
projectredcap.org
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Other degree type, please describe:
Major 1 (if applicable)
Other degree major, please describe:
05/08/2020 2:11pm
__________________________________
Anthropology
Archaeology
Biochemistry
Bioinformatics
Biology
Biomedical Science
Business
Chemistry
Computer/Information Technology Science
Earth and Planetary Sciences
Economics
Education
Engineering
Foreign Language
Forensic Science
Genetics
Government / Political Science
Health Care Profession (e.g. Nursing)
History
Math
Microbiology
Molecular Cell Biology
Neurobiology or Neuroscience
Philosophy
Physics
Physiology
Pre-Med
Pre-Vet
Psychology
Sociology
Other
Undecided
__________________________________
projectredcap.org
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Major 2 (if applicable)
Other degree major, please describe:
Institution
Anthropology
Archaeology
Biochemistry
Bioinformatics
Biology
Biomedical Science
Business
Chemistry
Computer/Information Technology Science
Earth and Planetary Sciences
Economics
Education
Engineering
Foreign Language
Forensic Science
Genetics
Government / Political Science
Health Care Profession (e.g. Nursing)
History
Math
Microbiology
Molecular Cell Biology
Neurobiology or Neuroscience
Philosophy
Physics
Physiology
Pre-Med
Pre-Vet
Psychology
Sociology
Other
Undecided
__________________________________
__________________________________
Degree status
Currently enrolled
Completed
No longer pursuing
Month degree completed
January
February
March
April
May
June
July
August
September
October
November
December
Year degree completed
Do you have any additional degrees to add?
05/08/2020 2:11pm
__________________________________
Yes
No
projectredcap.org
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Degree
Other degree, please describe:
Associate's degree or equivalent
Bachelor's degree or equivalent
Master's degree or equivalent
Doctoral degree or equivalent
Medical degree
Other degree
__________________________________
Associate's degree type
Associate of Science (A.S.)
Associate of Arts (A.A.)
Other
Undecided
Bachelor's degree type
Bachelor of Arts (B.A.)
Bachelor of Science (B.S.)
Bachelor of Science in Nursing (B.S.N.)
Other
Undecided
Master's degree type
Master of Arts (M.A.)
Master of Public Health (M.P.H)
Master of Science (M.S.) in biomedical science
field
Master of Science (M.S.) in another science or
engineering field
Master of Science in Nursing (M.S.N)
Master of Fine Arts (M.F.A)
Master of Business Administration (M.B.A)
Other
Undecided
Doctoral degree type
Doctor of Philosophy (Ph.D.)
Doctor of Science (D.Sc.)
Doctor of Education (E.D.)
Doctor of Veterinary Medicine (D.V.M.)
Juris Doctor (J.D.)
Other
Undecided
Doctoral degree type Ph.D., please describe:
Doctoral degree type D.Sc., please describe:
Medical degree type
Other degree type, please describe:
05/08/2020 2:11pm
__________________________________
__________________________________
Doctor of Medicine (M.D.)
Doctor of Dentistry (D.D.S)
Doctor of Optometry (O.D.)
Doctor of Pharmacy (Pharm.D.)
Other
Undecided
__________________________________
projectredcap.org
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Major 1 (if applicable)
Other degree major, please describe:
05/08/2020 2:11pm
Anthropology
Archaeology
Biochemistry
Bioinformatics
Biology
Biomedical Science
Business
Chemistry
Computer/Information Technology Science
Earth and Planetary Sciences
Economics
Education
Engineering
Foreign Language
Forensic Science
Genetics
Government / Political Science
Health Care Profession (e.g. Nursing)
History
Math
Microbiology
Molecular Cell Biology
Neurobiology or Neuroscience
Philosophy
Physics
Physiology
Pre-Med
Pre-Vet
Psychology
Sociology
Other
Undecided
__________________________________
projectredcap.org
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Major 2 (if applicable)
Other degree major, please describe:
Institution
Anthropology
Archaeology
Biochemistry
Bioinformatics
Biology
Biomedical Science
Business
Chemistry
Computer/Information Technology Science
Earth and Planetary Sciences
Economics
Education
Engineering
Foreign Language
Forensic Science
Genetics
Government / Political Science
Health Care Profession (e.g. Nursing)
History
Math
Microbiology
Molecular Cell Biology
Neurobiology or Neuroscience
Philosophy
Physics
Physiology
Pre-Med
Pre-Vet
Psychology
Sociology
Other
Undecided
__________________________________
__________________________________
Degree status
Currently enrolled
Completed
No longer pursuing
Month degree completed
January
February
March
April
May
June
July
August
September
October
November
December
Year degree completed
Do you have any additional degrees to add?
05/08/2020 2:11pm
__________________________________
Yes
No
projectredcap.org
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Degree
Other degree, please describe:
Associate's degree or equivalent
Bachelor's degree or equivalent
Master's degree or equivalent
Doctoral degree or equivalent
Medical degree
Other degree
__________________________________
Associate's degree type
Associate of Science (A.S.)
Associate of Arts (A.A.)
Other
Undecided
Bachelor's degree type
Bachelor of Arts (B.A.)
Bachelor of Science (B.S.)
Bachelor of Science in Nursing (B.S.N.)
Other
Undecided
Master's degree type
Master of Arts (M.A.)
Master of Public Health (M.P.H)
Master of Science (M.S.) in biomedical science
field
Master of Science (M.S.) in another science or
engineering field
Master of Science in Nursing (M.S.N)
Master of Fine Arts (M.F.A)
Master of Business Administration (M.B.A)
Other
Undecided
Doctoral degree type
Doctor of Philosophy (Ph.D.)
Doctor of Science (D.Sc.)
Doctor of Education (E.D.)
Doctor of Veterinary Medicine (D.V.M.)
Juris Doctor (J.D.)
Other
Undecided
Doctoral degree type Ph.D., please describe:
Doctoral degree type D.Sc., please describe:
Medical degree type
Other degree type, please describe:
05/08/2020 2:11pm
__________________________________
__________________________________
Doctor of Medicine (M.D.)
Doctor of Dentistry (D.D.S)
Doctor of Optometry (O.D.)
Doctor of Pharmacy (Pharm.D.)
Other
Undecided
__________________________________
projectredcap.org
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Major 1 (if applicable)
Other degree major, please describe:
05/08/2020 2:11pm
Anthropology
Archaeology
Biochemistry
Bioinformatics
Biology
Biomedical Science
Business
Chemistry
Computer/Information Technology Science
Earth and Planetary Sciences
Economics
Education
Engineering
Foreign Language
Forensic Science
Genetics
Government / Political Science
Health Care Profession (e.g. Nursing)
History
Math
Microbiology
Molecular Cell Biology
Neurobiology or Neuroscience
Philosophy
Physics
Physiology
Pre-Med
Pre-Vet
Psychology
Sociology
Other
Undecided
__________________________________
projectredcap.org
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Major 2 (if applicable)
Other degree major, please describe:
Institution
Anthropology
Archaeology
Biochemistry
Bioinformatics
Biology
Biomedical Science
Business
Chemistry
Computer/Information Technology Science
Earth and Planetary Sciences
Economics
Education
Engineering
Foreign Language
Forensic Science
Genetics
Government / Political Science
Health Care Profession (e.g. Nursing)
History
Math
Microbiology
Molecular Cell Biology
Neurobiology or Neuroscience
Philosophy
Physics
Physiology
Pre-Med
Pre-Vet
Psychology
Sociology
Other
Undecided
__________________________________
__________________________________
Degree status
Currently enrolled
Completed
No longer pursuing
Month degree completed
January
February
March
April
May
June
July
August
September
October
November
December
Year degree completed
Do you have any additional degrees to add?
05/08/2020 2:11pm
__________________________________
Yes
No
projectredcap.org
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Degree
Other degree, please describe:
Associate's degree or equivalent
Bachelor's degree or equivalent
Master's degree or equivalent
Doctoral degree or equivalent
Medical degree
Other degree
__________________________________
Associate's degree type
Associate of Science (A.S.)
Associate of Arts (A.A.)
Other
Undecided
Bachelor's degree type
Bachelor of Arts (B.A.)
Bachelor of Science (B.S.)
Bachelor of Science in Nursing (B.S.N.)
Other
Undecided
Master's degree type
Master of Arts (M.A.)
Master of Public Health (M.P.H)
Master of Science (M.S.) in biomedical science
field
Master of Science (M.S.) in another science or
engineering field
Master of Science in Nursing (M.S.N)
Master of Fine Arts (M.F.A)
Master of Business Administration (M.B.A)
Other
Undecided
Doctoral degree type
Doctor of Philosophy (Ph.D.)
Doctor of Science (D.Sc.)
Doctor of Education (E.D.)
Doctor of Veterinary Medicine (D.V.M.)
Juris Doctor (J.D.)
Other
Undecided
Doctoral degree type Ph.D., please describe:
Doctoral degree type D.Sc., please describe:
Medical degree type
Other degree type, please describe:
05/08/2020 2:11pm
__________________________________
__________________________________
Doctor of Medicine (M.D.)
Doctor of Dentistry (D.D.S)
Doctor of Optometry (O.D.)
Doctor of Pharmacy (Pharm.D.)
Other
Undecided
__________________________________
projectredcap.org
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Major 1 (if applicable)
Other degree major, please describe:
05/08/2020 2:11pm
Anthropology
Archaeology
Biochemistry
Bioinformatics
Biology
Biomedical Science
Business
Chemistry
Computer/Information Technology Science
Earth and Planetary Sciences
Economics
Education
Engineering
Foreign Language
Forensic Science
Genetics
Government / Political Science
Health Care Profession (e.g. Nursing)
History
Math
Microbiology
Molecular Cell Biology
Neurobiology or Neuroscience
Philosophy
Physics
Physiology
Pre-Med
Pre-Vet
Psychology
Sociology
Other
Undecided
__________________________________
projectredcap.org
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Major 2 (if applicable)
Other degree major, please describe:
Institution
Anthropology
Archaeology
Biochemistry
Bioinformatics
Biology
Biomedical Science
Business
Chemistry
Computer/Information Technology Science
Earth and Planetary Sciences
Economics
Education
Engineering
Foreign Language
Forensic Science
Genetics
Government / Political Science
Health Care Profession (e.g. Nursing)
History
Math
Microbiology
Molecular Cell Biology
Neurobiology or Neuroscience
Philosophy
Physics
Physiology
Pre-Med
Pre-Vet
Psychology
Sociology
Other
Undecided
__________________________________
__________________________________
Degree status
Currently enrolled
Completed
No longer pursuing
Month degree completed
January
February
March
April
May
June
July
August
September
October
November
December
Year degree completed
Do you have any additional degrees to add?
05/08/2020 2:11pm
__________________________________
Yes
No
projectredcap.org
Page 15 of 33
Degree
Other degree, please describe:
Associate's degree or equivalent
Bachelor's degree or equivalent
Master's degree or equivalent
Doctoral degree or equivalent
Medical degree
Other degree
__________________________________
Associate's degree type
Associate of Science (A.S.)
Associate of Arts (A.A.)
Other
Undecided
Bachelor's degree type
Bachelor of Arts (B.A.)
Bachelor of Science (B.S.)
Bachelor of Science in Nursing (B.S.N.)
Other
Undecided
Master's degree type
Master of Arts (M.A.)
Master of Public Health (M.P.H)
Master of Science (M.S.) in biomedical science
field
Master of Science (M.S.) in another science or
engineering field
Master of Science in Nursing (M.S.N)
Master of Fine Arts (M.F.A)
Master of Business Administration (M.B.A)
Other
Undecided
Doctoral degree type
Doctor of Philosophy (Ph.D.)
Doctor of Science (D.Sc.)
Doctor of Education (E.D.)
Doctor of Veterinary Medicine (D.V.M.)
Juris Doctor (J.D.)
Other
Undecided
Doctoral degree type Ph.D., please describe:
Doctoral degree type D.Sc., please describe:
Medical degree type
Other degree type, please describe:
05/08/2020 2:11pm
__________________________________
__________________________________
Doctor of Medicine (M.D.)
Doctor of Dentistry (D.D.S)
Doctor of Optometry (O.D.)
Doctor of Pharmacy (Pharm.D.)
Other
Undecided
__________________________________
projectredcap.org
Page 16 of 33
Major 1 (if applicable)
Other degree major, please describe:
05/08/2020 2:11pm
Anthropology
Archaeology
Biochemistry
Bioinformatics
Biology
Biomedical Science
Business
Chemistry
Computer/Information Technology Science
Earth and Planetary Sciences
Economics
Education
Engineering
Foreign Language
Forensic Science
Genetics
Government / Political Science
Health Care Profession (e.g. Nursing)
History
Math
Microbiology
Molecular Cell Biology
Neurobiology or Neuroscience
Philosophy
Physics
Physiology
Pre-Med
Pre-Vet
Psychology
Sociology
Other
Undecided
__________________________________
projectredcap.org
Page 17 of 33
Major 2 (if applicable)
Other degree major, please describe:
Institution
Anthropology
Archaeology
Biochemistry
Bioinformatics
Biology
Biomedical Science
Business
Chemistry
Computer/Information Technology Science
Earth and Planetary Sciences
Economics
Education
Engineering
Foreign Language
Forensic Science
Genetics
Government / Political Science
Health Care Profession (e.g. Nursing)
History
Math
Microbiology
Molecular Cell Biology
Neurobiology or Neuroscience
Philosophy
Physics
Physiology
Pre-Med
Pre-Vet
Psychology
Sociology
Other
Undecided
__________________________________
__________________________________
Degree status
Currently enrolled
Completed
No longer pursuing
Month degree completed
January
February
March
April
May
June
July
August
September
October
November
December
Year degree completed
Do you have any additional degrees to add?
05/08/2020 2:11pm
__________________________________
Yes
No
projectredcap.org
Page 18 of 33
Degree
Other degree, please describe:
Associate's degree or equivalent
Bachelor's degree or equivalent
Master's degree or equivalent
Doctoral degree or equivalent
Medical degree
Other degree
__________________________________
Associate's degree type
Associate of Science (A.S.)
Associate of Arts (A.A.)
Other
Undecided
Bachelor's degree type
Bachelor of Arts (B.A.)
Bachelor of Science (B.S.)
Bachelor of Science in Nursing (B.S.N.)
Other
Undecided
Master's degree type
Master of Arts (M.A.)
Master of Public Health (M.P.H)
Master of Science (M.S.) in biomedical science
field
Master of Science (M.S.) in another science or
engineering field
Master of Science in Nursing (M.S.N)
Master of Fine Arts (M.F.A)
Master of Business Administration (M.B.A)
Other
Undecided
Doctoral degree type
Doctor of Philosophy (Ph.D.)
Doctor of Science (D.Sc.)
Doctor of Education (E.D.)
Doctor of Veterinary Medicine (D.V.M.)
Juris Doctor (J.D.)
Other
Undecided
Doctoral degree type Ph.D., please describe:
Doctoral degree type D.Sc., please describe:
Medical degree type
Other degree type, please describe:
05/08/2020 2:11pm
__________________________________
__________________________________
Doctor of Medicine (M.D.)
Doctor of Dentistry (D.D.S)
Doctor of Optometry (O.D.)
Doctor of Pharmacy (Pharm.D.)
Other
Undecided
__________________________________
projectredcap.org
Page 19 of 33
Major 1 (if applicable)
Other degree major, please describe:
05/08/2020 2:11pm
Anthropology
Archaeology
Biochemistry
Bioinformatics
Biology
Biomedical Science
Business
Chemistry
Computer/Information Technology Science
Earth and Planetary Sciences
Economics
Education
Engineering
Foreign Language
Forensic Science
Genetics
Government / Political Science
Health Care Profession (e.g. Nursing)
History
Math
Microbiology
Molecular Cell Biology
Neurobiology or Neuroscience
Philosophy
Physics
Physiology
Pre-Med
Pre-Vet
Psychology
Sociology
Other
Undecided
__________________________________
projectredcap.org
Page 20 of 33
Major 2 (if applicable)
Other degree major, please describe:
Institution
Anthropology
Archaeology
Biochemistry
Bioinformatics
Biology
Biomedical Science
Business
Chemistry
Computer/Information Technology Science
Earth and Planetary Sciences
Economics
Education
Engineering
Foreign Language
Forensic Science
Genetics
Government / Political Science
Health Care Profession (e.g. Nursing)
History
Math
Microbiology
Molecular Cell Biology
Neurobiology or Neuroscience
Philosophy
Physics
Physiology
Pre-Med
Pre-Vet
Psychology
Sociology
Other
Undecided
__________________________________
__________________________________
Degree status
Currently enrolled
Completed
No longer pursuing
Month degree completed
January
February
March
April
May
June
July
August
September
October
November
December
Year degree completed
Do you have any additional degrees to add?
05/08/2020 2:11pm
__________________________________
Yes
No
projectredcap.org
Page 21 of 33
Degree
Other degree, please describe:
Associate's degree or equivalent
Bachelor's degree or equivalent
Master's degree or equivalent
Doctoral degree or equivalent
Medical degree
Other degree
__________________________________
Associate's degree type
Associate of Science (A.S.)
Associate of Arts (A.A.)
Other
Undecided
Bachelor's degree type
Bachelor of Arts (B.A.)
Bachelor of Science (B.S.)
Bachelor of Science in Nursing (B.S.N.)
Other
Undecided
Master's degree type
Master of Arts (M.A.)
Master of Public Health (M.P.H)
Master of Science (M.S.) in biomedical science
field
Master of Science (M.S.) in another science or
engineering field
Master of Science in Nursing (M.S.N)
Master of Fine Arts (M.F.A)
Master of Business Administration (M.B.A)
Other
Undecided
Doctoral degree type
Doctor of Philosophy (Ph.D.)
Doctor of Science (D.Sc.)
Doctor of Education (E.D.)
Doctor of Veterinary Medicine (D.V.M.)
Juris Doctor (J.D.)
Other
Undecided
Doctoral degree type Ph.D., please describe:
Doctoral degree type D.Sc., please describe:
Medical degree type
Other degree type, please describe:
05/08/2020 2:11pm
__________________________________
__________________________________
Doctor of Medicine (M.D.)
Doctor of Dentistry (D.D.S)
Doctor of Optometry (O.D.)
Doctor of Pharmacy (Pharm.D.)
Other
Undecided
__________________________________
projectredcap.org
Page 22 of 33
Major 1 (if applicable)
Other degree major, please describe:
05/08/2020 2:11pm
Anthropology
Archaeology
Biochemistry
Bioinformatics
Biology
Biomedical Science
Business
Chemistry
Computer/Information Technology Science
Earth and Planetary Sciences
Economics
Education
Engineering
Foreign Language
Forensic Science
Genetics
Government / Political Science
Health Care Profession (e.g. Nursing)
History
Math
Microbiology
Molecular Cell Biology
Neurobiology or Neuroscience
Philosophy
Physics
Physiology
Pre-Med
Pre-Vet
Psychology
Sociology
Other
Undecided
__________________________________
projectredcap.org
Page 23 of 33
Major 2 (if applicable)
Other degree major, please describe:
Institution
Anthropology
Archaeology
Biochemistry
Bioinformatics
Biology
Biomedical Science
Business
Chemistry
Computer/Information Technology Science
Earth and Planetary Sciences
Economics
Education
Engineering
Foreign Language
Forensic Science
Genetics
Government / Political Science
Health Care Profession (e.g. Nursing)
History
Math
Microbiology
Molecular Cell Biology
Neurobiology or Neuroscience
Philosophy
Physics
Physiology
Pre-Med
Pre-Vet
Psychology
Sociology
Other
Undecided
__________________________________
__________________________________
Degree status
Currently enrolled
Completed
No longer pursuing
Month degree completed
January
February
March
April
May
June
July
August
September
October
November
December
Year degree completed
Do you have any additional degrees to add?
05/08/2020 2:11pm
__________________________________
Yes
No
projectredcap.org
Page 24 of 33
Degree
Other degree, please describe:
Associate's degree or equivalent
Bachelor's degree or equivalent
Master's degree or equivalent
Doctoral degree or equivalent
Medical degree
Other degree
__________________________________
Associate's degree type
Associate of Science (A.S.)
Associate of Arts (A.A.)
Other
Undecided
Bachelor's degree type
Bachelor of Arts (B.A.)
Bachelor of Science (B.S.)
Bachelor of Science in Nursing (B.S.N.)
Other
Undecided
Master's degree type
Master of Arts (M.A.)
Master of Public Health (M.P.H)
Master of Science (M.S.) in biomedical science
field
Master of Science (M.S.) in another science or
engineering field
Master of Science in Nursing (M.S.N)
Master of Fine Arts (M.F.A)
Master of Business Administration (M.B.A)
Other
Undecided
Doctoral degree type
Doctor of Philosophy (Ph.D.)
Doctor of Science (D.Sc.)
Doctor of Education (E.D.)
Doctor of Veterinary Medicine (D.V.M.)
Juris Doctor (J.D.)
Other
Undecided
Doctoral degree type Ph.D., please describe:
Doctoral degree type D.Sc., please describe:
Medical degree type
Other degree type, please describe:
05/08/2020 2:11pm
__________________________________
__________________________________
Doctor of Medicine (M.D.)
Doctor of Dentistry (D.D.S)
Doctor of Optometry (O.D.)
Doctor of Pharmacy (Pharm.D.)
Other
Undecided
__________________________________
projectredcap.org
Page 25 of 33
Major 1 (if applicable)
Other degree major, please describe:
05/08/2020 2:11pm
Anthropology
Archaeology
Biochemistry
Bioinformatics
Biology
Biomedical Science
Business
Chemistry
Computer/Information Technology Science
Earth and Planetary Sciences
Economics
Education
Engineering
Foreign Language
Forensic Science
Genetics
Government / Political Science
Health Care Profession (e.g. Nursing)
History
Math
Microbiology
Molecular Cell Biology
Neurobiology or Neuroscience
Philosophy
Physics
Physiology
Pre-Med
Pre-Vet
Psychology
Sociology
Other
Undecided
__________________________________
projectredcap.org
Page 26 of 33
Major 2 (if applicable)
Other degree major, please describe:
Institution
Anthropology
Archaeology
Biochemistry
Bioinformatics
Biology
Biomedical Science
Business
Chemistry
Computer/Information Technology Science
Earth and Planetary Sciences
Economics
Education
Engineering
Foreign Language
Forensic Science
Genetics
Government / Political Science
Health Care Profession (e.g. Nursing)
History
Math
Microbiology
Molecular Cell Biology
Neurobiology or Neuroscience
Philosophy
Physics
Physiology
Pre-Med
Pre-Vet
Psychology
Sociology
Other
Undecided
__________________________________
__________________________________
Degree status
Currently enrolled
Completed
No longer pursuing
Month degree completed
January
February
March
April
May
June
July
August
September
October
November
December
Year degree completed
Do you have any additional degrees to add?
05/08/2020 2:11pm
__________________________________
Yes
No
projectredcap.org
Page 27 of 33
Degree
Other degree, please describe:
Associate's degree or equivalent
Bachelor's degree or equivalent
Master's degree or equivalent
Doctoral degree or equivalent
Medical degree
Other degree
__________________________________
Associate's degree type
Associate of Science (A.S.)
Associate of Arts (A.A.)
Other
Undecided
Bachelor's degree type
Bachelor of Arts (B.A.)
Bachelor of Science (B.S.)
Bachelor of Science in Nursing (B.S.N.)
Other
Undecided
Master's degree type
Master of Arts (M.A.)
Master of Public Health (M.P.H)
Master of Science (M.S.) in biomedical science
field
Master of Science (M.S.) in another science or
engineering field
Master of Science in Nursing (M.S.N)
Master of Fine Arts (M.F.A)
Master of Business Administration (M.B.A)
Other
Undecided
Doctoral degree type
Doctor of Philosophy (Ph.D.)
Doctor of Science (D.Sc.)
Doctor of Education (E.D.)
Doctor of Veterinary Medicine (D.V.M.)
Juris Doctor (J.D.)
Other
Undecided
Doctoral degree type Ph.D., please describe:
Doctoral degree type D.Sc., please describe:
Medical degree type
Other degree type, please describe:
05/08/2020 2:11pm
__________________________________
__________________________________
Doctor of Medicine (M.D.)
Doctor of Dentistry (D.D.S)
Doctor of Optometry (O.D.)
Doctor of Pharmacy (Pharm.D.)
Other
Undecided
__________________________________
projectredcap.org
Page 28 of 33
Major 1 (if applicable)
Other degree major, please describe:
05/08/2020 2:11pm
Anthropology
Archaeology
Biochemistry
Bioinformatics
Biology
Biomedical Science
Business
Chemistry
Computer/Information Technology Science
Earth and Planetary Sciences
Economics
Education
Engineering
Foreign Language
Forensic Science
Genetics
Government / Political Science
Health Care Profession (e.g. Nursing)
History
Math
Microbiology
Molecular Cell Biology
Neurobiology or Neuroscience
Philosophy
Physics
Physiology
Pre-Med
Pre-Vet
Psychology
Sociology
Other
Undecided
__________________________________
projectredcap.org
Page 29 of 33
Major 2 (if applicable)
Other degree major, please describe:
Institution
Anthropology
Archaeology
Biochemistry
Bioinformatics
Biology
Biomedical Science
Business
Chemistry
Computer/Information Technology Science
Earth and Planetary Sciences
Economics
Education
Engineering
Foreign Language
Forensic Science
Genetics
Government / Political Science
Health Care Profession (e.g. Nursing)
History
Math
Microbiology
Molecular Cell Biology
Neurobiology or Neuroscience
Philosophy
Physics
Physiology
Pre-Med
Pre-Vet
Psychology
Sociology
Other
Undecided
__________________________________
__________________________________
Degree status
Currently enrolled
Completed
No longer pursuing
Month degree completed
January
February
March
April
May
June
July
August
September
October
November
December
Year degree completed
Do you have any additional degrees to add?
05/08/2020 2:11pm
__________________________________
Yes
No
projectredcap.org
Page 30 of 33
Degree
Other degree, please describe:
Associate's degree or equivalent
Bachelor's degree or equivalent
Master's degree or equivalent
Doctoral degree or equivalent
Medical degree
Other degree
__________________________________
Associate's degree type
Associate of Science (A.S.)
Associate of Arts (A.A.)
Other
Undecided
Bachelor's degree type
Bachelor of Arts (B.A.)
Bachelor of Science (B.S.)
Bachelor of Science in Nursing (B.S.N.)
Other
Undecided
Master's degree type
Master of Arts (M.A.)
Master of Public Health (M.P.H)
Master of Science (M.S.) in biomedical science
field
Master of Science (M.S.) in another science or
engineering field
Master of Science in Nursing (M.S.N)
Master of Fine Arts (M.F.A)
Master of Business Administration (M.B.A)
Other
Undecided
Doctoral degree type
Doctor of Philosophy (Ph.D.)
Doctor of Science (D.Sc.)
Doctor of Education (E.D.)
Doctor of Veterinary Medicine (D.V.M.)
Juris Doctor (J.D.)
Other
Undecided
Doctoral degree type Ph.D., please describe:
Doctoral degree type D.Sc., please describe:
Medical degree type
Other degree type, please describe:
05/08/2020 2:11pm
__________________________________
__________________________________
Doctor of Medicine (M.D.)
Doctor of Dentistry (D.D.S)
Doctor of Optometry (O.D.)
Doctor of Pharmacy (Pharm.D.)
Other
Undecided
__________________________________
projectredcap.org
Page 31 of 33
Major 1 (if applicable)
Other degree major, please describe:
05/08/2020 2:11pm
Anthropology
Archaeology
Biochemistry
Bioinformatics
Biology
Biomedical Science
Business
Chemistry
Computer/Information Technology Science
Earth and Planetary Sciences
Economics
Education
Engineering
Foreign Language
Forensic Science
Genetics
Government / Political Science
Health Care Profession (e.g. Nursing)
History
Math
Microbiology
Molecular Cell Biology
Neurobiology or Neuroscience
Philosophy
Physics
Physiology
Pre-Med
Pre-Vet
Psychology
Sociology
Other
Undecided
__________________________________
projectredcap.org
Page 32 of 33
Major 2 (if applicable)
Other degree major, please describe:
Institution
Anthropology
Archaeology
Biochemistry
Bioinformatics
Biology
Biomedical Science
Business
Chemistry
Computer/Information Technology Science
Earth and Planetary Sciences
Economics
Education
Engineering
Foreign Language
Forensic Science
Genetics
Government / Political Science
Health Care Profession (e.g. Nursing)
History
Math
Microbiology
Molecular Cell Biology
Neurobiology or Neuroscience
Philosophy
Physics
Physiology
Pre-Med
Pre-Vet
Psychology
Sociology
Other
Undecided
__________________________________
__________________________________
Degree status
Currently enrolled
Completed
No longer pursuing
Month degree completed
January
February
March
April
May
June
July
August
September
October
November
December
Year degree completed
05/08/2020 2:11pm
__________________________________
projectredcap.org
Page 33 of 33
Employment
What is your current employment status?
(SELECT ALL THAT APPLY)
What is your current occupation?
Which of the following best describes the sector in
which you primarily work? Please select all that
apply.
Other, please describe:
Employed full-time
Employed part-time
Student full-time
Student part-time
Unemployed seeking employment
Unemployed not seeking employment
Stay-at-home parent, caretaker, or homemaker
Prefer not to answer
__________________________________
Academic setting (university or college)
Industry (for-profit company or business)
Government (federal, state, or local)
Non-profit organization
Other
__________________________________
Are you involved in research?
Yes
No
Have you ever received NIH research funding?
Yes
No
Please describe the funding you have received.
Is there anything else you would like to share about
your education and/or career, such as publications,
fellowships, or awards?
05/08/2020 2:11pm
__________________________________
__________________________________
projectredcap.org
| File Type | application/pdf |
| File Modified | 2023-05-10 |
| File Created | 2020-05-08 |