MAPI Research Trust provides reliable, comprehensive and up-to-date information services to research scientists, pharmaceutical companies, and governmental health agencies involved in the fields of Patient-Reported Outcomes (PRO) and Pharmaco-Epidemiology worldwide.
Home
CONFIDENTIAL DISCLOSURE

LIMITED USE AGREEMENT

for the Johns Hopkins Restless Legs Syndrome Quality of Life questionnaire
(RLS-QOL©)

THIS AGREEMENT WILL EXPIRE 7 DAYS AFTER RECEIPT.
THE COPY OF THE RLS-QOL SUPPLIED WITH THIS AGREEMENT MAY ONLY BE USED FOR EXAMINATION PURPOSES.
To view the questionnaire, please complete the following form:
Gender Male     Female
First Name
Last Name*
Company
Position
Title
Address*
Zip / Postal Code*
City*
State / Province
Country*
Phone
Fax
Email*
* required field


The information which concerns you is intended for Mapi Research Trust and its affiliates. It helps us to get to know you better and will be used to keep you informed of our products and services.
If you object, please tick this box

You have the right to access , modify , rectify and delete any data that concern you (art. 34 - Law "Informatique et Libertes" of January 6, 1978 - Data Protection). To exercise this right, contact Mapi Research Trust, 27 rue de la Villette, 69003 Lyon, France.

YOUR ACQUISITION OF AN EXAMINATION COPY OF RLS-QOL SIGNIFIES YOUR FULL AGREEMENT TO THE FOLLOWING CONDITIONS:

This License Agreement is for your limited use of the Johns Hopkins Restless Legs Syndrome Quality of Life questionnaire (RLS-QOL©) , © Richard Allen, 2001, All Rights Reserved.

This Agreement provides you with a personal, non-transferable, royalty-free, non-exclusive right and license to use the RLS-QOL for limited purpose of examining the suitability of the RLS-QOL for subsequent research and/or clinical use. This Agreement does not include: (1) any license for use of the RLS-QOL in research or in clinical practice(2) any license to sell or sublicense use of the RLS-QOL . The RLS-QOL may be examined only by persons whom you employ or whom you engage as independent contractors. You assume all risk for use of the RLS-QOL. This License only entitles you to obtain and use, for examination purposes, a single copy of the RLS-QOL.

You are not authorized to modify, retype, translate, copy or otherwise duplicate the RLS-QOL except with the further and prior written permission of LICENSOR (Mapi Research Trust).

New questionnaires distributed by MAPI Research Trust

ADCPQ (Alzheimer’s Disease Caregiver Preference Questionnaire)
Novartis Pharmaceuticals Corporation (USA)

FIS (Fatigue Impact Scale)
D-FIS (Daily Fatigue Impact Scale)
John Fisk (Canada)

HIV-SQUAD (Symptom Quality of Life Adherence) Questionnaire ®
Abbott France (France)

MOS-HIV (Medical Outcome Study-HIV Health Survey)
Albert Wu (USA)

MPQ (McGill Pain Questionnaire)
Ronald Melzack (Canada)

MPQ-SF (McGill Pain Questionnaire - Short Form)
Ronald Melzack (Canada)

Nausea Questionnaire 
Ronald Melzack (Canada)

ODI (Oswestry Disability Questionnaire)
Jeremy Fairbank (UK)

PI-ED (Paediatric Index of Emotional Distress)
GL Assessment (UK)

PRAC-Test (PRAgmatic Content and face validity Test)
Mapi Values (France)

SATMED-Q (Treatment Satisfaction with Medicines Questionnaire)
The EACCOS Group (Spain)

SF-MPQ-2 (Short-form McGill Pain Questionnaire)
Ronald Melzack (Canada) and IMMPACT (USA)


To access our catalog, please click here.



Coming soon!


Crohn and Anti-tnf Treatment Satisfaction questionnaire
Abbott France (France)



For any information, please contact:
contact@mapi-trust.org