Consent to Participate

Doctoral Dissertation Research Study:
Development and Initial Validation of the Lustica School Counselor Evaluation Tool (LSCET)

This study has been approved by the University of Rochester IRB, 5/21/2018.

Purpose of Research Study: I understand the purpose of this dissertation study is to develop and validate an instrument for school counselor evaluation by exploring the skills and attributes school administrators need to understand to evaluate school counselors.

Description of Procedures: I understand that if I decide to take part in this study, I will be asked to complete this survey, which will take approximately 30 minutes. The survey will begin with questions about my current job as a school counselor including years of employment, setting, and evaluation practices. I will then be asked to answer three questions about evaluation of items written to reflect best practice for school counselors and school counseling programs.

Risks and Benefits: I understand that there is a very small possibility that some of the survey questions may make me feel uncomfortable. I understand that I can skip any questions I do not want to answer or stop at any time. I understand that the researcher will not store any directly identifiable information about me with my survey responses. There are no other expected risks.

I understand that there are no direct benefits; however, I may benefit from participation by having my views, opinions, and experiences shared with the researcher. In addition, I understand that information from this study could potentially influence best practice in school counseling practice and training programs.

Inclusion Criteria: Participants for this study must hold current full-time, part-time or retired status as a school counselor and permanent or provisional certification as a school counselor in the United States.

Completion Benefits: I understand that upon completion of this survey, I will be entered in a random drawing to receive one of four $50 Amazon Gift Cards or a Fit Bit. The chances of winning will be 1:600. The drawing will take place in the Fall of 2018. I understand that if I win I will be notified via email. I understand that my email address will be deleted after sending the incentive. I understand that the researcher will send me the Fit Bit by mail and delete my address after sending. There will be no cost to me to participate in this study.

I understand that my participation in this study is completely voluntary. I am free not to participate or to withdraw at any time, for whatever reason. No matter what decision I make, I understand that there will be no penalty or loss of benefits to which I are otherwise entitled.

For more information or questions about this research you may contact Hennessey Lustica at

Please contact the University of Rochester Research Subjects Review Board at 265 Crittenden Blvd., CU 420628, Rochester, NY 14642, Telephone (585) 276-0005 or (877) 449-4441 for the following reasons:

· You wish to talk to someone other than the research staff about your rights as a research subject;
· To voice concerns about the research;
· To provide input concerning the research process;
· In the event the study staff could not be reached.

Question Title

* 1. I consent to participate in this study.