Introduction and Consent for Survey

You are invited to take part in a research study of reasonable accommodations in higher education. You were chosen for the study because you are either a college student with a disability or university personnel at a college. This form is part of a process called “informed consent” to allow you to understand this study before deciding whether to take part.

This study is being conducted by a researcher named Anita Schwartz, who is a doctoral student at Walden University. Anita will be conducting a survey. The following information is about the survey.

Background Information:
The purpose of this study is to get a better understanding of what the term reasonable accommodations mean to university personnel and adult students with disabilities in higher education.

If you agree to be in this study, you will be asked to:
• Take a survey (less than 20 minute's duration)
• After the survey, you can participate in either a focus group or an interview
Eighteen participants are needed for focus groups, 9 participants that are university personnel and 9 students. Additionally, 18 participants are needed for interviews, 9 participants that are university personnel and 9 that are students.

There is no compensation for participating in the survey. However, those who volunteer and are chosen (first come basis) to take part in the focus group or interview will receive a $20 Starbucks or gift card (participant's choice).

Voluntary Nature of the Study:
Your participation in this study is voluntary. This means that everyone will respect your decision of whether or not you want to be in the study. If you decide to join the study now, you can still change your mind during the study. If you feel stressed during the study, you may stop at any time. You may skip any questions that you feel are too personal.

Risks and Benefits of Being in the Study:
There will be no risk to you for taking part in this study. Your participation is voluntary and you can withdraw from the study at any time. The benefits of the study may include helping educators, students, and lawmakers to get a better understanding of what reasonable accommodations are from different perspectives. This can help lawmakers when changing or creating new law regarding accommodations in higher education.

Any information you provide will be kept confidential. The researcher will not use your personal information for any purposes outside of this research project. Also, the researcher will not include your name or anything else that could identify you in the study reports. Data will be kept secure by Anita Schwartz. Security measures will be taken through utilizing a secure fingerprinted protected laptop to store the raw data. Data will be kept for a period of at least 5 years, as required by the university.

Contacts and Questions:
If you have questions, you may contact the researcher via e-mail, If you want to talk privately about your rights as a participant, you can call Dr. Leilani Endicott. She is the Walden University representative who can discuss this with you. Her phone number is 1-800-925-3368, extension 3121210. Walden University’s approval number for this study is 03-27-13-0015116 and it expires on March 8, 2016.

If you are on the SurveyMonkey website taking the survey now, you can print or save this page now by using the print or save function in your browser.

* 1. Statement of Consent:
I am 18 years old or older, have read the above information, and I feel I understand the study well enough to make a decision about my involvement. By clicking below, I am agreeing to the terms described above, agree to participate in this study, and verifying that I am currently a student enrolled in classes at a college or university or an employee of a college or university.