Request institutional access

This is for research institutes, universities, hospitals, clinics, funders and companies that want to explore working with HAVEN as research partners. A request is a first step toward a conversation. This form is for organizations only. The next step is a trial with more families. It requires independent ethics review (an IRB) before any other family's data is collected.

Organization (required) The name of your institute, university, clinic, funder or company.

Type of organization (required) Pick the closest fit.

Your role (required) Pick the closest fit.

Your name (required) The name you'd like us to use if we write to you.

Work email (required) We'll use this address if we write to you.

What would you like to explore with us? (required)

Tell us in a few sentences what your group does and what you'd like to explore with us. Describe your work in general terms, for example the age range your clinic serves or the kind of research your lab does. Please leave out the details of any child, such as a name, an age, a school or a family. Please leave out health information, such as a diagnosis, a medication or a care plan. Please don't include details about a child or any health information in your message.

We collect what you enter in this form: your organization, its type, your role, your name, your work email and what you'd like to explore.

Read the privacy policy

Thank you

Your request has been received. If there's a fit, we'll write to you at the email you gave. This form is for organizations only.

Please check each field and try again. We need your organization, its type, your role, your name, your work email and what you'd like to explore.

We couldn't confirm that you're a person. Please try again.

This request looks like it includes details about a child. Please take them out and send it again. You can describe your work in general terms, such as the age range your clinic serves.

This request looks like it includes health information. Please take it out and send it again. You can describe your work in general terms, such as the kind of research your group does.

We already have your request, so there's no need to send it again.

Too many requests came in just now, so please wait a little while and try again.

Something went wrong on our side and your request wasn't sent. Please try again later, or write to Chad at chad@justiceapex.ai.

If the form doesn't work for you, email chad@justiceapex.ai instead.