Recruitment Form

I have read and agreed to the terms and conditions outlined in our disclaimer

Fill the form below to sign up your child for our current research study.

Parent/Guardian Information

Children Information

Please remember kids who are accepted in our study must be at most 7 years old. ×

Male     Female

My child has (check all that apply):   Normal hearing    Cochlear implants    Hearing aids

Bilingual     English

First Language     Second Language



Dear Parents,

If you are interested in having your children participate in our studies, please fill out the information on the Recruitment Form. This information will be entered into a database of potential participants for our laboratory only. Based on your child’s profile, we will contact you about any studies that your child can participate in. You are not obligated to participate in any study, and we will remove you from our contact list at any time that you ask.  Your information will also be removed automatically should the child become too old to participate (over 8 years of age).  All information that you submit through our website is confidential.  None of this information will be shared with or sold to any third-party entity.  All personal information will be kept in a password protected computer in our laboratory.  Information will only be used for recruitment for a GW IRB approved research study under Dr. James Mahshie.

There is always the risk of the breach of confidentiality. However, this is a secure database and every effort will be made to prevent any such breach. As such, the risks of loss of confidentiality are very small.

If you would like more information about the study or you would like to remove your information from the database, please contact James Mahshie at  Please contact the Office Of Human Research ( for any further information or questions regarding your rights and your child's rights as a research participant.

** By filling out this form you consent to being included in our recruitment pool.

I accept these terms

Dr. James Mahshie | George Washington University | Department of Speech and Hearing Science
2115 G Street NW, Washington, DC 20052