An injury can happen to anyone at anytime. If you do not wish your child to be enrolled into the TIC-TOC study, complete the form below. Once your child is placed on this list, the researchers will know not to enroll them in this study.

Note that this study will not enroll any child who is 18 years or older.

Tip: After each entry, TAB to the next field.

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You have selected an option that triggers this survey to end right now.
To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.