SGSH Faculty Subscription Form

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Subscription Fee information:

Faculty Subscription fee is $250 (one year). This amount does not include tax, If your institution is sales tax exempt,Please send your sales tax exemption certificate to Linda Gilmore at linda.gilmore@ttuhsc.edu within 48 hours to secure your active subscription to the SGSH website. Once the payment is successful you will receive an Unique Access Code that can be shared with your students. This unique code will give your students access to this at NO cost.

Subscription Period*

Sales tax exemption*

If you dont have promotional code, please proceed to next step

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Basic Info.:

Prefix

First name*

Last name*

Email*

Password*

Repeat password*

Select your Gender*

Highest Degree*

Department / Program*

University / College*

Course 1 (Entering course information is optional; however, if you plan to utilize the Learning Modules in the classroom, you must enter at least one course name to facilitate student account registration. If you do not have your course information at this time, you will be able to enter it later.)

Course 2 (Optional)

Course 3 (Optional)

City*

State*

Country*

Please answer all required fields

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Consent Statement:

You are being asked to take part in a research study called, Internal Implementation and External Field Testing of Sex and Gender-Based Medicine Online Multimedia Educational Products. This study is being conducted by the Texas Tech University Health Sciences Center School of Medicine.

The purpose of this study is to measure the effectiveness of the educational modules in increasing sex and gender knowledge regarding a specific disease state. If you decide to take part in this study, you will be asked to make the study modules accessible to your students as part of your curriculum. Your students will be asked if they would like to take part in this study when they set up their account to access the modules. Students do not have to take part in this study to use the modules. You will not know whether or not a student has chosen to take part in this study. At the end of the study, you will be sent a short, 5-minute survey and asked to complete it and return it to us via email.

The only risk related to this study is possible loss of confidentiality. You will not benefit from taking part in this study. However, this study will facilitate improvements and enhancements to the educational modules to better serve health care educators and students.

Your participation is voluntary. You may stop participating in this study at any time by contacting the investigator listed below.

This website is intended for educational purposes. The content of this website should not be construed as dictating an exclusive course of treatment and is not intended as medical advice, as all interventions should be tailored to the patient's specific medical situation. Please review and accept the Terms and Conditions of Use of this website to gain access to the educational products contained herein.

If you have any questions about this study, you may contact Linda Gilmore at linda.gilmore@ttuhsc.edu or 806.743.7645 . Please print or save this form in case you have questions later.

Please indicate your participation preference below.

Yes, I agree to utilize the educational modules with my students for research purposes, and I understand that my identity will not be deidentified. No, I do not agree to utilize the educational modules with my students for research purposes, and I understand that my identity will not be deidentified.

I have read the Terms and Conditions and I accept the terms and conditions.

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Confirmation:

Please confirm your details below and proceed to the payment gateway

Subscription Charge (pre tax in USD)
Total Subscription Charge (including Tax in USD)
First Name
Last Name
Email
Gender
Highest Degree
Department / Program
University / College
Course 1
Course 2
Course 3
City
State
Country
User Consent