Consent Form

Welcome!  You are invited to participate in a survey-based research study that is designed to explore the perceptions and practices of occupational therapists collaborating with teachers in school-based practice.  Prior to completing this brief anonymous survey please thoroughly read this form and click on “next” below, thereby denoting your consent. This study is being conducted by Vera Gallagher, co-investigator, under the direction of Dr. Courtney Richards, lead investigator as part of the Post-Professional Doctorate program at Quinnipiac University.

Background: Research supports the role of collaboration for school-based occupational therapists yet collaboration is met with challenges by practitioners.  The purpose of this study is to explore what are the perceptions and practices of school-based occupational therapists  collaborating with teachers. 

Procedures:  If you agree to participate in this study you will be directed to the survey after you click “Next” found at the bottom of this page. The survey will ask for basic demographic information as well as both closed and open-ended questions regarding your school-based collaborative practices with teachers. It will take approximately 10 minutes to complete.

Voluntary Nature of the Study:  This survey is voluntary. You may skip answering questions or end the survey at any time.

Risks and Benefits of Being in the Study:  This study poses no more risk than that of everyday life for participants.  A possible risk may be associated with the stress of the time commitment required to complete the survey.

Compensation: There is no financial or other types of compensation offered for participation in this research survey.

Confidentiality: Your responses are anonymous. No personal identifying information will be collected and your IP address will not be tracked.  All information is password protected.  The results of the study will be used for scholarly purposes and data will be reported in the aggregate with no personally identifiable information collected.

Contacts and Questions:  If you have any questions or concerns about this study, please feel free to contact Vera Gallagher, the secondary investigator via email at or Courtney Richards, the primary investigator at If you want more information about your rights as a participant contact Dr. Richard Feinn, Quinnipiac University Human Experimentation Committee/Institutional Review Board (HEB/IRB) Chair at

Clicking “Next” indicates that: You have read the above information and you voluntarily agree to participate.