A Father Daughter Survey Informed Consent

Please review and agree to these terms before beginning the survey. This survey is for all women.

* 1. The Fatherless Daughter Project

INFORMED CONSENT

Title: Exploring Daughters Experiences of Being Fathered or Fatherless

Principal Investigators: Karin L. Smithson, Ph.D and Denna Babul, R.N.


Introduction
You are invited to participate in a 4 minute research study. The purpose of the study is to look at relationships between daughters and fathers explore the understanding of being fathered or fatherless. You are invited to participate because you are a daughter. We will ask about your relational, living and developmental experiences with your father. Between 100-200 women will participate in this study.

Procedures
If you decide to participate, you will complete a one-time survey on a secure website. You will be asked to answer a series of questions. Your answers to these questions will be recorded on the website database but will remain confidential.

Risks
It is possible that participating in this study may cause you to become emotionally upset. If you become emotionally upset and want to talk to a mental health professional, please contact the primary researcher, Dr. Karin L. Smithson. She can be reached at Karin@doctorkarin.com or 678-232-8700 for a referral. The primary researcher is the co-founder of The Fatherless Daughter Project. In cases of referral, you will pay for all related costs.

Benefits
Participation in this study may not benefit you personally, although we hope that you gain insight about your relationship with your father. Overall, we hope to gain information about fathered and fatherless daughters.

Voluntary Participation and Withdrawal
Participation in this research is voluntary. You do not have to be in this study. You may refuse to participate at any time without penalty. You may stop or choose to not answer a question.

Confidentiality
All information you provide will be kept confidential, as permitted by the law. Dr. Karin Smithson and Denna Babul will have access to the information you provide.The information you provide will be stored on Karin Smithson’s password and firewall protected computer. You will not be identified personally. The findings will be summarized and reported in group form.

Contact Persons
Please contact Dr. Karin L. Smithson (678-232-8700; Karin@doctorkarin.com) or Denna Babul (404-790-3152; DennaBabul@gmail.com) if you have questions about this study.

Copy of Consent Form to Subject:
You may download or print a copy of this consent form to keep. If you are willing to volunteer for this study, please check the box below.

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