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Research Participant Consent Form
Braille Display Ergonomic Pain Survey
Research Participant,
This is a consent form, acknowledging the project below. Your participation in this study is voluntary and at any time you may refuse to participate, or stop participating. You must be 18 years of age or older to participate.
This survey will allow interpretations to be made to about what muscles are most affected and how much pain is caused, by use of braille displays.  The total anticipated time to complete the test will be approximately 2-15 minutes from start to finish including surveys and consent forms.
There is no anticipated risk of participating in this survey.  However, participants accessing the online survey via an unprotected wireless network are at greater risk of their confidentiality being compromised.  Therefore, it is advisable to participate via a password-protected network.
Please note that the data collected at all times during this project will be confidential and non-identifiale. Data will be stored on a password-protected computer, and all hard copies (if any) will be kept with either Dr. Magdy Akladios or myself at all times. Hardcopies will be destroyed within 3 years of the completion of the research project.
In appreciation to your participation, you will be entered into a sweepstakes for the opportunity to win gifts.  Other than this opportunity, there are no other perceived benefit of participating.
We appreciate your involvement and cooperation, and should you have any further questions regarding this research, please contact my faculty advisor, Dr. Magdy Akladios at or myself, Steven Follmer at
For any questions please contact Dr. Joel Persinger at
Click here to participate in the survey.
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