1. Consent Form

 
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I am a student in the Counseling Psychology Ph.D. Program at Seton Hall University and I am inviting you to participate in a research study investigating the emotional and physical factors that may have an impact on an individual’s employment status, following a diagnosis of Multiple Sclerosis (MS).

Data for this study will be collected from approximately March, 2012 through February, 2013 and will require a maximum time commitment of 30 minutes from each participant.

Participants are asked to provide their consent to the terms of this study by clicking the “I Consent” box at the end of this page. If a person does not wish to participate in this study, she or he should click the “I do not wish to participate” box at the end of this page, at which point she or he will automatically exit the survey. Individuals who consent to participate will be directed to a demographic questionnaire that serves to provide background information and to confirm that the participant meets the requirements to be included in the study. Upon completion of the demographic questionnaire and verification of eligibility, participants will complete the following assessments: the Revised Stress Related Growth Scale that was designed to measure positive or negative changes in a person’s life, following a diagnosis of MS; the Multiple Sclerosis Self-efficacy Scale, designed to measure a person’s belief in her or his ability to perform specific tasks of daily living; the Career Self-Efficacy Scale, designed to measure a person’s belief in her or his ability to perform specific tasks related to requesting necessary accommodations at work; and the American version of Guy’s Neurological Disability Scale, designed to measure the extent of a person’s MS-related disabilities.

Participation is voluntary and subjects may decline to participate or withdraw at any time without penalty. Participants may also choose not to answer any question.

The identity of each participant will remain anonymous. Each participant will be issued an identification number for the coding and analysis of data. All the data from questionnaires and assessment will be transferred to a USB memory key and will be stored in a locked cabinet maintained by the principal investigator.

Clicking “I CONSENT” below indicates that you have read and understood the information above and consent to participate in this study.
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