{"id":5043,"date":"2020-10-07T10:18:04","date_gmt":"2020-10-07T14:18:04","guid":{"rendered":"https:\/\/qprn.ca\/acces-projet-recherche\/"},"modified":"2023-09-26T17:10:00","modified_gmt":"2023-09-26T21:10:00","slug":"acces-projet-recherche","status":"publish","type":"page","link":"https:\/\/qprn.ca\/en\/acces-projet-recherche\/","title":{"rendered":"Research participation portal"},"content":{"rendered":"<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_4' style='display:none'><div id='gf_4' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data'  id='gform_4'  action='\/en\/wp-json\/wp\/v2\/pages\/5043#gf_4' data-formid='4' novalidate>\n        <div id='gf_progressbar_wrapper_4' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<h3 class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>3<\/span><span class='gf_step_page_name'> &#8211; YOUR INFORMATIONS<\/span>\n        \t<\/h3>\n            <div class='gf_progressbar gf_progressbar_orange' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_orange percentbar_33' style='width:33%;'><span>33%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_4_1' class='gform_page ' 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gf_right_third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_16'>Language understood and spoken<\/label><div class='ginput_container ginput_container_select'><select name='input_16' id='input_4_16' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Click to select<\/option><option value='French' >French<\/option><option value='English' >English<\/option><option value='French and English' >French and English<\/option><\/select><\/div><\/li><li id=\"field_4_35\" class=\"gfield gfield--type-select gfield--input-type-select gf_left_half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_35'>What biological sex were you assigned at birth?<\/label><div class='ginput_container ginput_container_select'><select name='input_35' id='input_4_35' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Click to select<\/option><option value='Female' >Female<\/option><option value='Male' >Male<\/option><option value='Intersex' >Intersex<\/option><option value='I prefer not to disclose information about my sex' >I prefer not to disclose information about my sex<\/option><\/select><\/div><\/li><li id=\"field_4_51\" class=\"gfield gfield--type-select gfield--input-type-select gf_right_half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_51'>How do you identify yourself in terms of gender?<\/label><div class='ginput_container ginput_container_select'><select name='input_51' id='input_4_51' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Click to select<\/option><option value='Woman' >Woman<\/option><option value='Man' >Man<\/option><option value='I don&#039;t identify with the binary gender' >I don&#039;t identify with the binary gender<\/option><option value='I prefer not to disclose information about my gender' >I prefer not to disclose information about my gender<\/option><\/select><\/div><\/li><li id=\"field_4_19\" class=\"gfield gfield--type-select gfield--input-type-select gf_left_half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_19'>What region do you live in?<\/label><div class='ginput_container ginput_container_select'><select name='input_19' id='input_4_19' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Click to select<\/option><option value='Abitibi-T\u00e9miscamingue' >Abitibi-T\u00e9miscamingue<\/option><option value='Bas-Saint-Laurent' >Bas-Saint-Laurent<\/option><option value='Capitale Nationale' >Capitale Nationale<\/option><option value='Centre-du-Qu\u00e9bec' >Centre-du-Qu\u00e9bec<\/option><option value='Chaudi\u00e8re-Appalaches' >Chaudi\u00e8re-Appalaches<\/option><option value='C\u00f4te-Nord' >C\u00f4te-Nord<\/option><option value='Estrie' >Estrie<\/option><option value='Gasp\u00e9sie-\u00celes-de-la-Madeleine' >Gasp\u00e9sie-\u00celes-de-la-Madeleine<\/option><option value='Lanaudi\u00e8re' >Lanaudi\u00e8re<\/option><option value='Laurentides' >Laurentides<\/option><option value='Laval' >Laval<\/option><option value='Mauricie' >Mauricie<\/option><option value='Mont\u00e9r\u00e9gie' >Mont\u00e9r\u00e9gie<\/option><option value='Montr\u00e9al' >Montr\u00e9al<\/option><option value='Nord-du-Qu\u00e9bec' >Nord-du-Qu\u00e9bec<\/option><option value='Saguenay-Lac-Saint-Jean' >Saguenay-Lac-Saint-Jean<\/option><option value='Outaouais' >Outaouais<\/option><option value='Canadian province out of Qu\u00e9bec' >Canadian province out of Qu\u00e9bec<\/option><option value='Out of Canada' >Out of Canada<\/option><\/select><\/div><\/li><li id=\"field_4_20\" class=\"gfield gfield--type-select gfield--input-type-select gf_right_half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_20'>In the case of projects that require one or more visits to a researcher&#039;s laboratory, can you come to:<\/label><div class='ginput_container ginput_container_select'><select name='input_20' id='input_4_20' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Click to select<\/option><option value='Sherbrooke' >Sherbrooke<\/option><option value='Montr\u00e9al' >Montr\u00e9al<\/option><option value='Qu\u00e9bec' >Qu\u00e9bec<\/option><option value='Chicoutimi' >Chicoutimi<\/option><option value='Gatineau' >Gatineau<\/option><option value='Other' >Other<\/option><option value='No, I don&#039;t want to travel' >No, I don&#039;t want to travel<\/option><\/select><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_4_29' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_4_2' class='gform_page' data-js='page-field-id-29' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_4_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_4_40\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">YOUR MAIN PAIN<\/h2><\/li><li id=\"field_4_59\" class=\"gfield gfield--type-select gfield--input-type-select field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_59'>What is the location of your main pain?<\/label><div class='ginput_container ginput_container_select'><select name='input_59' id='input_4_59' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Generalized pain (pain all over or almost all over the body)' >Generalized pain (pain all over or almost all over the body)<\/option><option value='Head' >Head<\/option><option value='Face' >Face<\/option><option value='Neck' >Neck<\/option><option value='Shoulder(s)' >Shoulder(s)<\/option><option value='Arm(s)' >Arm(s)<\/option><option value='Elbow(s)' >Elbow(s)<\/option><option value='Wrist(s)' >Wrist(s)<\/option><option value='Hand(s)' >Hand(s)<\/option><option value='Upper back' >Upper back<\/option><option value='Lower back' >Lower back<\/option><option value='Chest' >Chest<\/option><option value='Abdomen\/stomach' >Abdomen\/stomach<\/option><option value='Hip(s)' >Hip(s)<\/option><option value='Buttock(s)' >Buttock(s)<\/option><option value='Anal region' >Anal region<\/option><option value='Genital region' >Genital region<\/option><option value='Leg(s)' >Leg(s)<\/option><option value='Knee(s)' >Knee(s)<\/option><option value='Ankle(s)' >Ankle(s)<\/option><option value='Feet' >Feet<\/option><\/select><\/div><\/li><li id=\"field_4_64\" class=\"gfield gfield--type-multiselect gfield--input-type-multiselect field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_64'>What is the cause of this pain?<\/label><div class='gfield_description' id='gfield_description_4_64'>To choose more than one answer, click in the drop-down menu as many times as necessary.<\/div><div class='ginput_container ginput_container_multiselect'><select multiple='multiple'  size='7' name='input_64[]' id='input_4_64' class='large gfield_select'   aria-invalid=\"false\"  aria-describedby=\"gfield_description_4_64\"><option value='Workplace injury' >Workplace injury<\/option><option value='Injury at home' >Injury at home<\/option><option value='Sport injury' >Sport injury<\/option><option value='Motor vehicle injury' >Motor vehicle injury<\/option><option value='Other type of injury than those listed above' >Other type of injury than those listed above<\/option><option value='Posture or repetitive movements' >Posture or repetitive movements<\/option><option value='Following surgery' >Following surgery<\/option><option value='Following treatment for cancer other than surgery (e.g., chemotherapy, radiotherapy)' >Following treatment for cancer other than surgery (e.g., chemotherapy, radiotherapy)<\/option><option value='Age-related degenerative illness (e.g., osteoarthritis)' >Age-related degenerative illness (e.g., osteoarthritis)<\/option><option value='Inflammatory or immune disease (e.g. rheumatoid arthritis, lupus)' >Inflammatory or immune disease (e.g. rheumatoid arthritis, lupus)<\/option><option value='Following a stressful event' >Following a stressful event<\/option><option value='Following another type of illness NOT related to cancer' >Following another type of illness NOT related to cancer<\/option><option value='No precise cause or undiagnosed' >No precise cause or undiagnosed<\/option><option value='Other reason or circumstances' >Other reason or circumstances<\/option><\/select><\/div><\/li><li id=\"field_4_27\" class=\"gfield gfield--type-select gfield--input-type-select field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_27'>Since when do you suffer from it?<\/label><div class='ginput_container ginput_container_select'><select name='input_27' id='input_4_27' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Click to select<\/option><option value='Click to select' >3 months or less<\/option><option value='More than 3 months' >More than 3 months<\/option><\/select><\/div><\/li><li id=\"field_4_37\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_37'>Please select the number that best describes your pain during the past 7 days, on a scale from 0 (no pain) to 10 (worst pain I can imagine).<\/label><div class='ginput_container ginput_container_select'><select name='input_37' id='input_4_37' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Click to select<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><\/select><\/div><\/li><li id=\"field_4_62\" class=\"gfield gfield--type-multiselect gfield--input-type-multiselect field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_62'>What are you currently using for the treatment of your pain?<\/label><div class='gfield_description' id='gfield_description_4_62'>To choose more than one answer, click in the drop-down menu as many times as necessary.<\/div><div class='ginput_container ginput_container_multiselect'><select multiple='multiple'  size='7' name='input_62[]' id='input_4_62' class='large gfield_select'   aria-invalid=\"false\"  aria-describedby=\"gfield_description_4_62\"><option value='prescription drugs (which require a prescription from a doctor, pharmacist or nurse practitioner)?' >prescription drugs (which require a prescription from a doctor, pharmacist or nurse practitioner)?<\/option><option value='over-the-counter medications (that do not require a prescription, for example: ac\u00e9taminop\u00e8ne, Ibuprof\u00e8ne)?' >over-the-counter medications (that do not require a prescription, for example: ac\u00e9taminop\u00e8ne, Ibuprof\u00e8ne)?<\/option><option value='physical and \/ or psychological approaches (eg exercise, massage, psychotherapy, physiotherapy, osteopathy, etc.)' >physical and \/ or psychological approaches (eg exercise, massage, psychotherapy, physiotherapy, osteopathy, etc.)<\/option><option value='I do not use any treatment' >I do not use any treatment<\/option><\/select><\/div><\/li><li id=\"field_4_41\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">YOUR SECONDARY PAIN<\/h2><\/li><li id=\"field_4_61\" class=\"gfield gfield--type-select gfield--input-type-select field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_61'>What is the location of your secondary pain?<\/label><div class='ginput_container ginput_container_select'><select name='input_61' id='input_4_61' class='medium gfield_select'     aria-invalid=\"false\" ><option value='I don&#039;t have secondary pain' >I don&#039;t have secondary pain<\/option><option value='Generalized pain (pain all over or almost all over the body)' >Generalized pain (pain all over or almost all over the body)<\/option><option value='Head' >Head<\/option><option value='Face' >Face<\/option><option value='Neck' >Neck<\/option><option value='Shoulder(s)' >Shoulder(s)<\/option><option value='Arm(s)' >Arm(s)<\/option><option value='Elbow(s)' >Elbow(s)<\/option><option value='Wrist(s)' >Wrist(s)<\/option><option value='Hand(s)' >Hand(s)<\/option><option value='Upper back' >Upper back<\/option><option value='Lower back' >Lower back<\/option><option value='Chest' >Chest<\/option><option value='Abdomen\/stomach' >Abdomen\/stomach<\/option><option value='Hip(s)' >Hip(s)<\/option><option value='Buttock(s)' >Buttock(s)<\/option><option value='Anal region' >Anal region<\/option><option value='Genital region' >Genital region<\/option><option value='Leg(s)' >Leg(s)<\/option><option value='Knee(s)' >Knee(s)<\/option><option value='Ankle(s)' >Ankle(s)<\/option><option value='Feet' >Feet<\/option><\/select><\/div><\/li><li id=\"field_4_65\" class=\"gfield gfield--type-multiselect gfield--input-type-multiselect field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_65'>What is the cause of this pain?<\/label><div class='gfield_description' id='gfield_description_4_65'>To choose more than one answer, click in the drop-down menu as many times as necessary.<\/div><div class='ginput_container ginput_container_multiselect'><select multiple='multiple'  size='7' name='input_65[]' id='input_4_65' class='large gfield_select'   aria-invalid=\"false\"  aria-describedby=\"gfield_description_4_65\"><option value='Workplace injury' >Workplace injury<\/option><option value='Injury at home' >Injury at home<\/option><option value='Sport injury' >Sport injury<\/option><option value='Motor vehicle injury' >Motor vehicle injury<\/option><option value='Other type of injury than those listed above' >Other type of injury than those listed above<\/option><option value='Posture or repetitive movements' >Posture or repetitive movements<\/option><option value='Following surgery' >Following surgery<\/option><option value='Following treatment for cancer other than surgery (e.g., chemotherapy, radiotherapy)' >Following treatment for cancer other than surgery (e.g., chemotherapy, radiotherapy)<\/option><option value='Age-related degenerative illness (e.g., osteoarthritis)' >Age-related degenerative illness (e.g., osteoarthritis)<\/option><option value='Inflammatory or immune disease (e.g. rheumatoid arthritis, lupus)' >Inflammatory or immune disease (e.g. rheumatoid arthritis, lupus)<\/option><option value='Following a stressful event' >Following a stressful event<\/option><option value='Following another type of illness NOT related to cancer' >Following another type of illness NOT related to cancer<\/option><option value='No precise cause or undiagnosed' >No precise cause or undiagnosed<\/option><option value='Other reason or circumstances' >Other reason or circumstances<\/option><\/select><\/div><\/li><li id=\"field_4_55\" class=\"gfield gfield--type-select gfield--input-type-select field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_55'>Since when do you suffer from it?<\/label><div class='ginput_container ginput_container_select'><select name='input_55' id='input_4_55' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Click to select<\/option><option value='3 months or less' >3 months or less<\/option><option value='More than 3 months' >More than 3 months<\/option><\/select><\/div><\/li><li id=\"field_4_54\" class=\"gfield gfield--type-select gfield--input-type-select field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_54'>Please select the number that best describes your pain during the past 7 days, on a scale from 0 (no pain) to 10 (worst pain I can imagine).<\/label><div class='ginput_container ginput_container_select'><select name='input_54' id='input_4_54' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Click to select<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><\/select><\/div><\/li><li id=\"field_4_63\" class=\"gfield gfield--type-multiselect gfield--input-type-multiselect field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_63'>What are you currently using for the treatment of your pain?<\/label><div class='gfield_description' id='gfield_description_4_63'>To choose more than one answer, click in the drop-down menu as many times as necessary.<\/div><div class='ginput_container ginput_container_multiselect'><select multiple='multiple'  size='7' name='input_63[]' id='input_4_63' class='large gfield_select'   aria-invalid=\"false\"  aria-describedby=\"gfield_description_4_63\"><option value='prescription drugs (which require a prescription from a doctor, pharmacist or nurse practitioner)?' >prescription drugs (which require a prescription from a doctor, pharmacist or nurse practitioner)?<\/option><option value='over-the-counter medications (that do not require a prescription, for example: Robax\u00ae, Tylenol\u00ae, or Advil\u00ae)?' >over-the-counter medications (that do not require a prescription, for example: Robax\u00ae, Tylenol\u00ae, or Advil\u00ae)?<\/option><option value='physical and \/ or psychological approaches (eg exercise, massage, psychotherapy, physiotherapy, osteopathy, etc.)' >physical and \/ or psychological approaches (eg exercise, massage, psychotherapy, physiotherapy, osteopathy, etc.)<\/option><option value='I do not use any treatment' >I do not use any treatment<\/option><\/select><\/div><\/li><li id=\"field_4_58\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">OTHER PAIN<\/h2><\/li><li id=\"field_4_57\" class=\"gfield gfield--type-multiselect gfield--input-type-multiselect field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_57'>Do you have other pain?<\/label><div class='gfield_description' id='gfield_description_4_57'>To choose more than one answer, click in the drop-down menu as many times as necessary.<\/div><div class='ginput_container ginput_container_multiselect'><select multiple='multiple'  size='7' name='input_57[]' id='input_4_57' class='medium gfield_select'   aria-invalid=\"false\"  aria-describedby=\"gfield_description_4_57\"><option value='Head' >Head<\/option><option value='Face' >Face<\/option><option value='Neck' >Neck<\/option><option value='Shoulder(s)' >Shoulder(s)<\/option><option value='Arm(s)' >Arm(s)<\/option><option value='Elbow(s)' >Elbow(s)<\/option><option value='Wrist(s)' >Wrist(s)<\/option><option value='Hand(s)' >Hand(s)<\/option><option value='Upper back' >Upper back<\/option><option value='Lower back' >Lower back<\/option><option value='Chest' >Chest<\/option><option value='Abdomen\/stomach' >Abdomen\/stomach<\/option><option value='Hip(s)' >Hip(s)<\/option><option value='Buttock(s)' >Buttock(s)<\/option><option value='Anal region' >Anal region<\/option><option value='Genital region' >Genital region<\/option><option value='Leg(s)' >Leg(s)<\/option><option value='Knee(s)' >Knee(s)<\/option><option value='Ankle(s)' >Ankle(s)<\/option><option value='Feet' >Feet<\/option><\/select><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_4_31' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_4_31' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' 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