1. Outcomes Instrument Database: Web-Survey

You are being asked to give feedback on the Outcomes Instrument Database, developed by Dr. Allen Heinemann, Jennifer Moore, and others at the Rehabilitation Institute of Chicago. We would like to know what you think about the Database’s usability, layout, and content.

The name of the study is Outcomes Instrument Database, IRB Project # STU00020690. If you agree to participate, you will be asked to respond to the following survey questions about your experiences reviewing the Database at www.RehabMeasures.org. This survey will take approximately 20 minutes.

There are no risks associated with this study. You may skip any questions you do not wish to answer and you may quit at any time. No identifying information will be recorded with your answers. There are no benefits to you from participating in this study, but your feedback may help improve the Outcomes Instrument Database, which other clinicians and researchers may use. You do not have to participate in this study. This survey is being hosted by Survey Monkey. Terms of Service may be viewed at http://www.surveymonkey.com/termsofuse.aspx.

The results of the research study may be published, but your name will not be used. Your participation in this research study is completely voluntary. You can withdraw at any time. Choosing not to be in this study or to stop being in this study will not result in any penalty to you or loss of benefit to which you are entitled. Your choice not to be in this study will not negatively affect any rights to which you are otherwise entitled, including, your present or future employment.

If you have any questions, please call us promptly. Dr. Allen Heinemann is the person in charge of this research study and can be reached at 312-238-2802. You can also contact Jennifer Moore at 312-238-5624. Questions about your rights as a research subject may be directed to the Office for the Protection of Research Subjects at Northwestern Institutional Review Board at (312) 503-9338.

Question Title

* 1. If you wish to participate, please select the Accept button to begin the survey. Print a copy of this consent page for your records. If you do not wish to participate in this study, please select the Decline button and close your browser.

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