Consent Form

You are asked to be in a study about stigma and help seeking. You were chosen because you identify as lesbian, gay, or bisexual. Please read this form and ask any questions you have before agreeing to be in the study.

This study is being done by Sarah Afriecq, a graduate student in the PsyD program at Marywood University for a Master’s thesis project.

Background Information

The goal of this study is to find out how stigma, symptoms, gender, and sexual orientation affect help seeking in LGB individuals.


If you agree to be in this study, you will be asked to do the following things. After you read and understand this consent form, you will fill out a demographic form. You will also fill out forms about stigma, symptoms, and help seeking. The study will take about 30 minutes to do. You will be debriefed after you complete the study.

Risks and Benefits

One possible risk of this study is slight emotional trouble due to being asked about mental health concerns. Should you experience any distress, you can contact:

National Alliance on Mental Illness
1-800-950-NAMI (6264)

Your participation will add to our knowledge about the mental health and use of mental healthcare services in the LGB community.


The records of this study will be kept private. In any published report, we will not include information that will identify you. Your name will not be tied to any of your survey responses, nor will any electronic information be used from the computer you used for this study (e.g., IP address). Research records will be kept in a locked file. Only the researchers will see the records. While it is understood that no computer transmission can be perfectly safe, efforts will be made to keep your survey information private. Records will be kept for no more than three years and will be destroyed. The flash drive will be erased and put in an industrial shredder.

Participation is Voluntary

Your decision whether or not to participate will not affect your relations with the researcher or Marywood University. You may withdraw from this study at any time before clicking the “Next” button without affecting those relationships. To withdraw, simply exit the survey using the “x” button located on the top right-hand corner of the screen.

Your responses to the survey will be anonymous. Once you complete the study you may click on a link to submit your email address for a drawing for one of two $50 prepaid Amazon gift cards. The winners will be emailed the gift card code. The names entered into the drawing will be stored on a separate server and will in no way be connected to your responses to the survey.

Contacts and Questions

The researcher doing this study is Sarah Afriecq.

If you have questions about the research, you may contact Sarah Afriecq at (570) 677-7687, or Dr. Ahmed at (570-348-6226). Dr. Ahmed is an associate professor at Marywood University.

If you have any questions now, or later, related to the rights of the research participants or research-related injuries (where applicable), you may contact Dr. Maria Edwards at Marywood University, Assistant Vice President for Research, at (570) 961-4778 or

You may keep a copy of this form for your records by copying or printing from your computer screen.

If you have or think you may HIV, please do not complete this study.

By clicking the button below <Next button> and proceeding with this study, I accept that I have read and understood the above and consent to partake in this study.