INFORMED CONSENT PAGE
Dear participant,
Metro Health is inviting you to take a short survey for research. This survey will take you around 5-10 minutes to complete. Your participation in this survey is completely voluntary, and you can withdraw any time. There are no negative consequences if you don’t want to take it. If you start the survey, you can always change your mind and stop at any time. To take this survey, you must be at least 18 years old and a D.C. resident
This survey is anonymous. Your name and contact details will NOT be required. Only the zip code of your residence is requested.
The purpose of this research study is to help us understand the willingness and hesitancy towards the COVID-19 vaccination among people residing in D.C. This short survey has questions on your zip code, demographics such as age, gender, race-ethnicity, education, employment status, and underlying health conditions. It includes questions on your vaccination status and the reason you chose to get vaccinated or not. Your responses are confidential and will only be accessed by the research team to analyze the data and conduct the study. By answering these questions, you will be helping researchers identify and address priority areas for COVID-19 research and intervention development. We may share the findings of this study with publications and presentations.
This research is being overseen by Western IRB. Please contact them if you have any questions, concerns, or complaints that are not being answered by the research team or if you wish to talk to someone independent of the research team. If you want to contact someone on the research team, email abulusu@metrohealthdc.org
By checking the box below, you are agreeing to the terms of this research study and to participate in this survey.
Metro Health is inviting you to take a short survey for research. This survey will take you around 5-10 minutes to complete. Your participation in this survey is completely voluntary, and you can withdraw any time. There are no negative consequences if you don’t want to take it. If you start the survey, you can always change your mind and stop at any time. To take this survey, you must be at least 18 years old and a D.C. resident
This survey is anonymous. Your name and contact details will NOT be required. Only the zip code of your residence is requested.
The purpose of this research study is to help us understand the willingness and hesitancy towards the COVID-19 vaccination among people residing in D.C. This short survey has questions on your zip code, demographics such as age, gender, race-ethnicity, education, employment status, and underlying health conditions. It includes questions on your vaccination status and the reason you chose to get vaccinated or not. Your responses are confidential and will only be accessed by the research team to analyze the data and conduct the study. By answering these questions, you will be helping researchers identify and address priority areas for COVID-19 research and intervention development. We may share the findings of this study with publications and presentations.
This research is being overseen by Western IRB. Please contact them if you have any questions, concerns, or complaints that are not being answered by the research team or if you wish to talk to someone independent of the research team. If you want to contact someone on the research team, email abulusu@metrohealthdc.org
By checking the box below, you are agreeing to the terms of this research study and to participate in this survey.