Survey of Korean Transracial Adoptees
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Informed Consent Form

Title of Study: Sense of Belonging in Korean Transracial Adoptees

Investigator: Danielle Godon

Brief description of project and procedures to be followed: In this survey, you will be asked to answer a series questions regarding your adoption. You will also be asked questions about your personality, outlook on life, experiences with discrimination, feelings of belonging, and family. Some questions will be multiple choice and some will ask for short answer responses or explanations.

This project has been approved by the Department of Psychology and Education at Mount Holyoke College. The following informed consent is required by Mount Holyoke College for all participants in human subjects research:

A. My participation is voluntary.
B. I may withdraw my consent and discontinue participation in this study at any time. I will not be penalized in any way if I decide not to participate.
C. The procedures to be followed in the project will be explained to me, and any questions I may have about the aims or methods of the project will be answered.
D. All of the information from this study will be treated as strictly confidential. If I provide my address in order to receive a report of this research upon its completion, that information will not be used to identify me in the data. The data will be password protected and accessible only to the investigator(s).
E. The results of this study will be made part of a final research report and may be used in papers submitted for publication or presented at professional conferences, but under no circumstances will my name or other identifying characteristics be included.

If you have any questions about this research, contact Danielle Godon (the investigator) at godon22d@mtholyoke.edu or Mount Holyoke College’s Institutional Review Board, at institutional-review-board@mtholyoke.edu.

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1. If you understand the above, and consent to participate in the project, please indicate your consent:

If you understand the above, and consent to participate in the project, please indicate your consent: Yes: I understand and consent to participate in this study.

No: I do not consent to participate in this study.

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2. By checking the boxes below, you are confirming you are 18 years or older and that you will take this survey once and only once.

By checking the boxes below, you are confirming you are 18 years or older and that you will take this survey once and only once. I am 18 years or older

I will only take this survey once

3. Email address

Please note that your information is confidential; in the final report, results will only be reported in aggregate to ensure your confidentiality.

Email address Please note that your information is confidential; in the final report, results will only be reported in aggregate to ensure your confidentiality.

Survey of Korean Transracial AdopteesExit this survey

*1. If you understand the above, and consent to participate in the project, please indicate your consent:

*2. By checking the boxes below, you are confirming you are 18 years or older and that you will take this survey once and only once.

3. Email addressPlease note that your information is confidential; in the final report, results will only be reported in aggregate to ensure your confidentiality.

Survey of Korean Transracial Adoptees
Exit this survey

*
1. If you understand the above, and consent to participate in the project, please indicate your consent:

*
2. By checking the boxes below, you are confirming you are 18 years or older and that you will take this survey once and only once.

3. Email address

Please note that your information is confidential; in the final report, results will only be reported in aggregate to ensure your confidentiality.