Consent Form

Lindsey Snaychuk Dr. Melanie O'Neill
Principal Investigator Registered Psychologist
Department of Psychology Department of Psychology
Vancouver Island University Vancouver Island University
The researchers are looking to investigate prevalence rates of technology-facilitated sexual violence and its associated psychological effects.

As a participant in this research, you will be asked to dedicate approximately 15-35 minutes of your time to complete several online questionnaires. The questionnaires will provide the research with information about your online habits, experiences with technology-facilitated sexual violence, and risk factors. Each one will only take a few minutes to complete.

There are no known harms associated with your participation in the research. However, due to the sensitive nature of the content on the questionnaires, it is possible that you may feel uncomfortable or experience mental distress during the survey. A list of resources that may be helpful are listed on the last page of this document in the event that you choose to seek support following the survey. If answering a question is too uncomfortable or distressing, participants are free to refrain from answering it, and either proceed with the study or withdraw if necessary.

The survey software allows for any questions to be skipped and/or not answered. Answers on any survey may be changed at any point until the final survey has been submitted. You may withdraw from the study at any time without penalty until all surveys have been submitted, at which time it will be impossible to remove the data, as participation is anonymous.

Your responses to this survey will be stored in SurveyMonkey’s database. Please be advised that SurveyMonkey's servers are located in the United States and are therefore subject to the U.S. Partiot Act ( Data will then be inputted on to SPSS in order to be analyzed and saved on a secured drive that only accessible to the principal investigator and the student supervisor. Data input will be conducted by the principal investigator and overseen by the supervisor. Consent forms and data collected for the purposes of this study will be kept on the locked drive for the duration of the project, and then deleted from both SurveyMonkey and the drive after the project’s completion. This project’s aimed completion is May 31st, 2020. For more information regarding SurveyMonkey’s policies on privacy and security, follow the links provided:

All records will be kept strictly confidential. All data will be stored electronically at Vancouver Island University on a password-protected drive.  Only the principle investigator and supervisor will have access to data. Data will be kept for five years from the time of publication, and at which time the data will be deleted. Results of this research will be written in a final report and may be presented at an academic conference. Information will not be made public in any way that identifies individual participants.

If you are interested in the results of this study, they will be posted on the VIU Social Sciences Facebook page at: upon the study's completion. Please note that only global results, not individual results, will be disclosed.

If you have any concerns about your treatment as a research participant in this study, please contact the VIU Research Ethics Officer, by telephone at (250) 740-6631 or by email at

You may copy, print, or screenshot the information from this consent form for future reference. You are also more than welcome to stop by Dr. O'Neill's office in building 356 room 360 where hard copies of this form will be available in a filing folder posted to the outside of Dr. O'Neill's door.

If you have any questions or concerns about the research at any time during your participation, please do not hesitate to contact the student researcher or the research supervisor. Please see resources below.
Community Resources

VIU Counselling Services Crisis Services
900 Fifth Street 203-2000 Island Highway North
Nanaimo BC, V96 5S5 Nanaimo, BC V9S 5W3
Building 200, Third Floor 250-739-5710
250-740-6416 Hours: 10:00 AM - 6:15 PM, M-F
Hours: 8:30-4, M-F  
BC Crisis Line (24 Hours) Nanaimo 24 Hour Crisis Line
1-877-392-7583 1-888-494-3888
LGBT Help Line  
1-800-268-9688 (if you wish to call)  
647-694-4275--SMS (online chatroom)  

Question Title

* 1. I have read and understand the information provided in the form above, and I understand that I can ask questions or withdraw at any time. I hereby consent to participate in the research under the following terms:

I consent to having my anonymous responses utilized in this research.
I consent to answering the questions provided.
I consent to having the results of this study to be utilized in future academic endeavors.