Introduction and Consent

INFORMED CONSENT FORM

EMPOWER Research is gathering information to help guide research towards novel rehabilitation treatments for anxiety, depression, and post-traumatic stress disorder (PTSD) for first responders and military personnel in Canada and the United States.

Principal Investigator:     Venu Karapareddy, MD

                                            Centre for Neurology Studies,  HealthTech Connex Inc.

                                            13737 96 Ave, Suite 204

                                            Surrey, BC    V3V 0C6

You are invited to participate in this research study because you are a first responder or military personnel. The survey should take you approximately 15 minutes to complete. If you do not want to answer a question, please select "prefer not to say" and move on to the next question. Once you have completed the survey, please choose the “submit” button.

The purpose of the study is to collect insights about the use of, and interest in medical marijuana and psychedelic-assisted therapy programs for mental and physical health. Understanding this will help direct future research efforts and novel therapy options.

There is no direct benefit to you from your participation in the study. Information learned from the study may help other people in the future. The only alternative is to not participate in this study.

The information that you will share will remain strictly confidential and will be used solely for the purposes of this research. Your answers to open-ended questions may be used verbatim in presentations and publications, but you will not be identified.

To minimize the risk of security breaches and to help ensure your confidentiality we recommend that you use standard safety measures such as signing out of your computer account, closing your browser and/or locking your screen or device when you are no longer using them / when you have completed the study. This survey software used for data collection is housed on servers located in the continental USA and the data is subject to USA privacy legislation. You are not being asked to provide any personal identifying information. Neither your name, email or IP address will be collected during the study survey. However, indirect identifiers included in demographic data collection (such as, city/province/state/country of work, age range, sex, type of first responder (title), and years of employment) will be collected.

Representatives of the research ethics review board - Advarra IRB (an independent ethics committee that reviewed the ethical aspects of this study to help protect the rights and welfare of study participants), may have access to the information collected for this study.

You will not be compensated directly for participating in the survey. On the last page of the survey, you will have the option to click a link and enter your email address in a separate form to enter a draw for prizes, and/or to be contacted for future research studies if you would like. Draw prizes will include cash and clothing, and range in value from approximately $50 to $500. Your contact information will not be linked to your survey responses.

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