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PHARMACY SERVICES

Greetings, and thank you for participating in this survey.

This survey is part of a study to determine hospital practices in California with regard to Pharmacy Services. First, the informed consent document. Please review before taking the survey. Note: This is the only question you are required to answer.
1.Informed Consent for Participation

You are invited to participate in a survey that will help us to better understand the impact of proposed regulations in the hospital industry.

You have been asked to participate because you have been identified as a key stakeholder for this project. The information collected will enable the California Center for Rural Policy to contribute to public comment provisions of the legislative process and make recommendations regarding the fiscal impact of the proposed regulatory changes.

Overall Description of Participation

If you decide to be a part of this project, you will be asked to participate in an on-line survey administered by the California Center for Rural Policy.

In addition, data collected in electronic files will be stored on a server on which users must be authorized by the evaluation team for access. CCRP will store electronic data for a period of five years. Neither your name nor your professional affiliation will be identified in connection with the survey. Your responses are encrypted and your computer's IP address will not be recorded.

Length of Participation

The survey should take approximately 15-30 minutes to complete.

Compensation

No compensation will be provided for participation in the on-line survey.

Volunteer Statement

You are a volunteer. The decision to participate in this project is completely up to you. If you decide to be in the project, you may stop and withdraw your consent to participate at any time. You will not be treated any differently if you decide not to participate in the project or if you stop once you have started.

Confidentiality Statement

Your identity will not be linked to any information you provide as part of this study. If results are shared with other people at meetings or in published articles, your name will be kept private.

Rights of Participants

If you have any concerns with this study or questions about your rights as a participant, contact the Institutional Review Board for the Protection of Human Subjects at irb@humboldt.edu or (707) 826-5165.

For specific questions about this study, you may contact the program coordinator, Dawn Arledge Director of Health Research at the California Center for Rural Policy (707-826-3400), or the program principal investigator, Connie Stewart, California Center for Rural Policy, HSU (707-826-3402).

Statement of Informed Consent

I have read and understood what it means to be a part of this project. I understand that the investigator or program coordinator will answer any questions I may have concerning the investigation or the procedures at any time. I also understand that my participation is entirely voluntary and that I may decline to enter this study or may withdraw from it at any time without jeopardy. I understand that the investigator may terminate my participation in the study at any time.

Investigator: Connie Stewart
Executive Director of the California Center for Rural Policy at
Humboldt State University

Do you agree to the above terms? By clicking "Yes," and typing your name, you consent that you have read this document and are willing to answer the questions in this survey. [This information will be retained in a separate file from the one which is used for data analysis and will not be disclosed to anyone.](Required.)
This survey has been set up so that you may pause and return to it before completion. We appreciate your taking the time to respond. Some demographic information about your hospital.
2.What size is your hospital?
3.Is your hospital part of a larger network or system of hospitals?
Current Progress,
0 of 22 answered
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