Life Goals Survey Consent Form

 

 

Description of Procedure

 

You will be asked to complete a survey that asks about life goals, health, social support, spirituality, and ethnic identity.  Your participation in this study is completely voluntary, and you are free to discontinue participation at any time.  If you wish to participate, please read the following sections and click the consent agreement below.

 

 

Participant’s Rights

 

I understand that my participation in this study may contribute to a greater understanding of the factors that influence life goals throughout adulthood.  I understand that there are no risks involved in my participation.  I also understand that my course grade is not contingent on my participation in the study.

 

I understand that my responses will be kept in the strictest confidence and will be available only to the researchers. 

 

Please note:

  1. Survey data will be identified by number only.

  2. There will be no connection between participant’s email and identification number.

  3. Consent forms will be kept in a secure file only accessible to the Director of Research Activities.

  4. Survey data will be kept in a secure file, identified only by number and accessible to the Director of Research Activities.

 

I may choose not to participate or may withdraw at any time during the study.  I also understand that I am free to withhold my response to any particular question.

 

I understand that upon completion, I will be given a full explanation of the research and that the investigator will be willing to answer any questions I have, either now, during, or after the study.  If I am uncomfortable with any part of this project or my questions have not been answered to my satisfaction, I may contact Professor Andrew Fiala the Chairperson of the Institutional Review Board of the University of Wisconsin-Green Bay, at (920) 465-2169.  The Institutional Review Board of the University of Wisconsin-Green Bay is a group of faculty and staff who review each proposal to ensure that participant rights are respected and that research is conducted in a safe and ethical manner.

 

 

Consent to Participate

 

I acknowledge that I understand my rights as a research participant as outlined above.  I acknowledge that my participation is fully voluntary.  By clicking the consent box below, I freely consent to act as a participant in this research.

 

 

I consent to act as a participant in this research.

 

E-mail Address NOTE: Your survey will be assigned an identification number.  E-mail address is for verification only.