Sign up to the Evidence 4 Quality Improvement (E4QI) Randomised Coffee Trial!

Thank you for your interest in the Evidence4QI Randomised Coffee Trial

We're delighted that you would like to take part. Please provide your contact details below.

By providing your details you are consenting to us contacting you to regarding the Evidence4QI Randomised CoffeeTrial and providing your details to your coffee partner.

If you have any questions or would like us to remove your details from the Randomised Coffee Trial please email Evidence4QI@gmail.com

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* 1. What is your name?

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* 2. What organisation do you work for?

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* 3. At what email address would you like to be contacted?

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* 4. What telephone number can your coffee partner contact you on?

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* 5. What is your job role?

Quality Improvement

Librarian / knowledge specialist

Patient

Clinician

Administration

Management

Research

Education

Other

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* 6. Where are you based geographically?

North West England

North East England

South West England

South East England

London

Wales

Scotland

Ireland

Northern Ireland

Canada

United States

Australia

New Zealand

Other (please specify)