Consent To Complete Sexual Assault Survey
You are invited to take part in a survey. This introduction contains information that will help you decide whether to complete the survey.
Heartly House is the only organization in Frederick County to provide comprehensive services to victims of domestic violence, sexual assault, human trafficking, and child abuse. We have teamed with community leaders to put together a sexual assault prevention strategy and need your input. This survey about sexual abuse and sexual assault will help Heartly House develop a prevention strategy by better understanding community members’ knowledge and attitudes about sexual violence.
Key Information
Things you should know:
Heartly House is the only organization in Frederick County to provide comprehensive services to victims of domestic violence, sexual assault, human trafficking, and child abuse. We have teamed with community leaders to put together a sexual assault prevention strategy and need your input. This survey about sexual abuse and sexual assault will help Heartly House develop a prevention strategy by better understanding community members’ knowledge and attitudes about sexual violence.
Key Information
Things you should know:
- The purpose of the survey is to learn about Frederick County’s knowledge and attitudes about sexual violence.
- Please note: this survey is about sexual abuse and sexual assault. Some individuals completing the survey may be triggered by the questions. If you feel you may be negatively impacted by completing the survey, please stop now. If you begin the survey and find yourself “triggered” please contact Heartly House at 301-662-8800, 24 hours a day.
- The benefits of your participation to you: 1) an opportunity to participate in an important, potentially life-saving project and 2) a way to express your concerns about individual safety in Frederick County.
Taking part in this research project is voluntary. You do not have to participate and you can stop at any time. However, by submitting your survey, at the end of the questions, you have given consent to participate in this project.
Who can take part in this study? Individuals of all ages, genders, races, socioeconomic backgrounds, etc., may participate.
What will happen to me in this study? As mentioned previously, questions on this survey may impact you negatively. If you begin to feel “triggered,” during completion, please close the survey. Heartly House is available for 24-hour support at 301-662-8800.
You do not have to answer any questions you do not want to answer. Because this study collects information about you, one of the risks of this research is a loss of confidentiality.
How much of my time will be needed to take part in this study? Completing the survey should not take no more than 20 minutes of your time.
Who can take part in this study? Individuals of all ages, genders, races, socioeconomic backgrounds, etc., may participate.
What will happen to me in this study? As mentioned previously, questions on this survey may impact you negatively. If you begin to feel “triggered,” during completion, please close the survey. Heartly House is available for 24-hour support at 301-662-8800.
You do not have to answer any questions you do not want to answer. Because this study collects information about you, one of the risks of this research is a loss of confidentiality.
How much of my time will be needed to take part in this study? Completing the survey should not take no more than 20 minutes of your time.
What will happen to the information collected from this survey?
Neither your email address nor your Internet Services Provider address will show up on your survey. No place in the survey asks for your name, address, email address, or other identifying information. In fact, individual responses are not as important to us as are themes identified from the group. Responses will be consolidated to provide us an overall picture of all the respondents.
Who can I contact about this study?
Please contact Heartly House representatives listed below to:
- Obtain more information about the project or survey
- Report an illness, injury, or other problem (you may also need to tell your regular doctors)
- Express a concern about the project or survey
Heartly House Representative: Inga James, Executive Director
Email: ijames@heartlyhouse.org
Phone: 301-662-8800
Email: ijames@heartlyhouse.org
Phone: 301-662-8800