Consent Form

Identification of Investigators & Purpose of Study
You are being asked to participate in a research study conducted by Gabriela Zamora and supervised by Dr. Hong Ni of California State University, Fresno. The purpose of this study is to obtain information regarding the different roles of school professionals with respect to Response to Intervention (RTI). This study will contribute to the student’s completion of her master’s thesis.

Research Procedures
You will be asked to provide answers to a series of questions related to the different roles for school professionals and your experience implementing RTI.

Time Required
Participation in this study will require approximately 5-10 minutes of your time.

Risks
The investigator does not perceive risks from your involvement in this study that are beyond the risks associated with everyday life.

Benefits
Potential benefits from participation in this study include a better understanding of the different roles for school professionals in the context of RTI and additional knowledge regarding school professionals’ experiences related to RTI implementation.

Confidentiality
The results of this research will be presented at a thesis defense. While individual responses are anonymously obtained and recorded online through Survey Monkey, data is kept in the strictest confidence. Names and email addresses are not associated with individual survey responses. The researchers will know if a participant has submitted a survey, but will not be able to identify individual responses, therefore maintaining anonymity for the survey. The results of this project will be coded in such a way that the respondent’s identity will not be attached to the final form of this study. Aggregate data will be presented representing averages or generalizations about the responses as a whole. All data will be stored in a secure location accessible only to the researcher. Upon completion of the study, all information will be destroyed. Final aggregate results will be made available to participants upon request.

Participation & Withdrawal
Your participation is entirely voluntary. You are free to choose not to participate. Should you choose to participate, you can withdraw at any time without consequences of any kind.

Questions about the Study
If you have questions or concerns during the time of your participation in this study, or after its completion, please contact:
Dr. Hong Ni
Chair, Thesis
California State University, Fresno
Telephone: 559-278-1726

Questions about Your Rights as a Research Subject
Dr. Constance Jones
Committee on the Protection of Human Subjects
California State University, Fresno
Telephone: 559-278-4468

Giving of Consent
I have read this consent form and I understand what is being requested of me as a participant in this study. I freely consent to participate and certify that I am at least 18 years of age. By completing and submitting this anonymous online survey, I am consenting to participate in this research.

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