Survey Account and Information Request

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Survey software is available for anyone who is affiliated with the University of Arkansas at Fayetteville. However, only those who have IRB approval can request Qualtrics.

All surveys published MUST BE APPROVED by the Institutional Review Board (IRB). Once a draft of the proposed survey has been submitted to the IRB, a "Statement of Clearance" must be forwarded to IT Services, via uasurvey@uark.edu, verifying IRB compliance and approval. For more information on IRB compliance, see the "Institutional Review Board Meeting Schedule and Protocol Submission Deadlines" on the Institutional Review Board web page.

Name:

Your UARK Email Address:

Departmental Code (4-digits, e.g. MATH):

Contact Phone:

Note: Publisher Licenses require verification of IRB approval. Please provide your IRB information below. If you prefer to email this information to IT Services directly, you will be given temporary User privileges until it is received. Please email uasurvey@uark.edu.

The following information is required to complete the survey request:

IRB Protocol: Protocol Title: Project Period: Start Date: Expiration Date: Additional Comments or Questions: