Introduction and Consent

The following is a survey about potential adversity or challenges in your life as a result of your child's food allergy, and the ways that you cope or handle such potential adversity or challenges. This survey is intended to be taken by an adult over the age of 18, answering on behalf of their food allergic child. If you have more than one child with food allergy, we ask that you complete a single survey based on one of your child's experiences with food allergy, and then re-take it, answering for your experience with any of your other children with food allergy.

There may be questions that are not applicable to your particular circumstances, or responses that do not completely explain your particular circumstances. In the event this occurs, we kindly ask that you select the choice that you think best answers the question asked. We have tried to provide choices that would limit any confusion in how to respond. Please try to answer as many questions as possible if you do not wish to complete the entire survey. We thank you in advance for your participation. This survey should take approximately 15 minutes to complete.

The information obtained from this survey will be anonymous and stored in a secure location. Your identity will not be linked to your responses. Your participation in this survey is completely voluntary. We do not anticipate that your participation in this survey would result in any risk to you. This study is survey based and does not involve any physical contact with you.

The next section will give you the opportunity to elect to participate in this survey. We thank you in advance if you indeed choose to participate.

Please read the following statement carefully, and then respond below if you are interested in participating.

Question Title

* 1. The following are a series of questions and statements pertaining to your background and your child's food allergy. We do not ask for any personal information that would in any way specifically identify you or any family member. We understand that some of the questions we ask involve sensitive topics, but we are only asking this information to better understand the life of those who care for children with food allergies. Participation in this study is completely voluntary. The information will be kept in a secure location under electronic encryption. No personally identifiable information will be collected. We intend to publish the results in the medical literature. This survey is being conducted by The University of Michigan Medical School and the University of Michigan Food Allergy Center.

I hereby consent to participate in this study titled Adversity and Resilience Among Caregivers of Food Allergic Children (HUM00095394). I understand that information obtained in this survey will potentially contribute to a future publication in the medical literature. The study authors will keep any data collected under electronic encryption and password protection. The authors are not collecting any information that can be used to identify any individual participant.

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