Thank you for participating in our study! This will take about 10 - 15 minutes of your time, and the results will be used to advocate better support in the workplace for caregivers managing and recovering from cancer. 
Before we begin the survey, we need to obtain your informed consent to participate.  
Purpose and Procedures: 
This study is being run by Leslie Forde, Founder and CEO of Mom’s Hierarchy of Needs and Dr. Kelly Basile, Associate Professor of Management at Emmanuel College. This study explores the self-care behaviors and workplace supports for caregivers managing and recovering from cancer. It involves the conduct of a 15-minute online survey.  
Risks and Discomforts: 
You may experience some anxiety or discomfort if the survey leads to you recall a particularly challenging time or experience. In order to prevent this from happening, you may refuse to answer any questions you are not comfortable with, take a break from the research or withdraw from the study at any time.  
Potential Benefits: 
At the conclusion of the study, you will be able to access reporting on the results via the Mom’s Hierarchy of Needs website. In addition, participants may choose to subscribe to the Mom’s Hierarchy of Needs email newsletter ( which provides support and guidance on self-care practices for caregivers.  
Protection of Confidentiality / Anonymity: 
Your identity will be protected throughout this research. Your name/identity/email address will not be linked to your survey responses. While every attempt will be made to preserve participant anonymity and confidentiality, this can’t be guaranteed due to the limits introduced by technology use. Given that the survey asks about attitudes toward work, participants may want to consider taking the survey using their private, personal internet to avoid any risks associated with employer-monitored networks. 
Voluntary Participation: 
Your participation in this research is voluntary; you may choose not to participate. You also have the right to stop participating at any time for any reason. You will not be penalized in any way should you decide not to participate or if you withdraw from the study. 
Contact Information: 
If you have any questions or concerns about this research, please contact
Kelly Basile, PhD. 
Phone: 617-732-1602 
Address: Office EAB 430-A, Emmanuel College, 400 The Fenway, Boston, MA 02115 
If you have any questions about your rights as a participant in this study, or if problems arise, please contact: 
Dr. Laurie Johnston 
Chair, Emmanuel College Committee for the Protection of Human Participants in Research (CPHPR) 
Phone: 617-264-7723 
The CPHPR is a group of people who review research proposals and may also review study records to ensure that research is designed and conducted in an ethical and safe way.

Question Title

* 1. Consent: 
By clicking on the ‘Continue’ button below, I acknowledge that I am aged 18 or over and have read the information above and am agreeing to participate in this study. I have been given an opportunity and contact information for any questions I have relating to this research.