Consent to Participate in a

NON-BIOMEDICAL Research Study

Title: Family Functions of Children with Learning Disabilities

Faculty Sponsor Information: Dr. Shannon Claxton

Principal Student/Faculty Investigator:     Amanda Parr

Contact Information:                                   anp006@morningside.edu 712-420-1594

Introduction

The purpose of my research is to examine the family relationships in a student’s life with diagnosed learning disabilities.

 WHO CAN PARTICIPATE?

The participants must be 18 years of age or older. They also must be a parent or legal guardian of a child no older than 18.  

 HOW LONG WILL I BE IN THIS STUDY?

This should take you approximately 25-30 minutes to complete. 

 WHAT WILL HAPPEN DURING THIS STUDY?

You will be taking surveys that go over the relationships you have with your child. You can skip any question that you do not feel comfortable answering.

 WHAT ARE THE RISKS OF THE STUDY?

There are no foreseeable risks to participating in this study, but if you experience negative feelings you may discontinue your participation at any time.

 WHAT ARE THE BENEFITS OF THIS STUDY?

You may not benefit personally from being in this study.  However, we hope that, in the future, other people might benefit from this study because if we can figure out where the deficits are in the relationships with  children with learning disabilities; we may be able to figure out how to get rid of those deficits or somehow improve the relationships for those children.

 IS BEING IN THIS STUDY VOLUNTARY?

Your participation is voluntary. You may choose not to participate or you may discontinue your participation at any time without penalty or loss of benefits to which you are otherwise entitled.  

 ARE MY RECORDS CONFIDENTIAL?

Confidentiality will be maintained to the degree permitted by the technology used. Your participation in this online survey involves risks similar to a person’s everyday use of the Internet. Please note that this survey is anonymous. We are unable to extract anonymous data from the database should you wish to have it withdrawn later. The records of this study will be kept confidential to the extent permitted by law.  In any report about this study that might be published, you will not be identified.

 WHOM MAY I CONTACT IF I HAVE QUESTIONS?

You may ask any questions you have now or later about this research. Please use the faculty sponsor and/or investigator contact information listed above to ask any questions you may have later.

 By completing the survey you are agreeing that this research study has been explained to you, that your questions have been answered, and that you agree to take part in this study can print a copy of this form if you desire. 

Question Title

* 1. I am 18 years old or older.

Question Title

* 2. If you understand the statements above and freely consent to participate in the study, click on the "I Agree" button to begin the survey

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