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 Patient Health Questionnaire Screener
(PHQ Screener©)

THIS AGREEMENT WILL EXPIRE 7 DAYS AFTER RECEIPT.
THE COPY OF THE PHQ Screener 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 PHQ SCREENER SIGNIFIES YOUR FULL AGREEMENT TO THE FOLLOWING CONDITIONS:

This License Agreement is for your limited use of the Patient Health Questionnaire Screener (PHQ Screener©) , PHQ © Pfizer Inc. All Rights Reserved.

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

You are not authorized to modify, retype, translate, copy or otherwise duplicate the PHQ Screener 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)

PHQ (Patient Health Questionnaire Screeners
Pfizer Inc. (USA)

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

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