Introduction

 RESEARCH SUBJECT CONSENT FORM
Title:                                       Project Boundless
Protocol No.:                          120180166
Sponsor:                                Community Education Group, Inc.
Investigator:                           A. Toni Young
                                               3233 Pennsylvania Avenue SE
                                               Washington, DC 20020
                                               United States
Daytime Phone Number:        202-465-1590

You are being invited to take part in a research study.  A person who takes part in a research study is called a research subject, or research participant.

What should I know about this research?
  • Someone will explain this survey to you.
  • This form sums up that explanation.
  • Taking part in this research survey is voluntary. Whether you take part is up to you.
  • You can choose not to take part. There will be no penalty or loss of benefits to which you are otherwise entitled.
  • You can agree to take part and later change your mind. There will be no penalty or loss of benefits to which you are otherwise entitled.
  • If you don’t understand, ask questions.
  • Ask all the questions you want before you decide.
Why is this research being done?
The purpose of this research is to inform how to best establish a global dialogue among non-government and community organizations concerning the impact of HIV treatment and cure-related research. This survey will also help us understand how finding an HIV cure may affect organizational sustainability.About 500 participants are being asked to complete a research survey.

How long will I be in this research?
We expect that your taking part in this research will last approximately 20-45 minutes depending on participants’ responses.

What happens to me if I agree to take part in this research?
Participants 18 years and older that represent nonprofit and community-based organizations are being asked to participate in an online survey. This survey will be administered using the SurveyMonkey web-based system.

Could being in this research hurt me?
There are minimal risks associated with your participation in this survey. As some of the questions may be of a confidential nature or require concentration, we recommend you complete the survey when you will have 30 minutes in private and that you close the web browser after completing the survey. No identifying information you share about yourself or your organization will be included in reports produced from this survey.

Will it cost me money to take part in this research?
There are no costs associated with participating in this survey.

Will being in this research benefit me?
There are no benefits to you from your taking part in this survey. We cannot promise any benefits to others from your taking part in this research.

Checking this box documents your consent to take part in this research:

Question Title

* 1. Checking this box documents your consent to take part in this research:

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