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Community-Led Needs Assessment

1.
CONSENT TO PARTICIPATE
COMMUNITY-LED NEEDS ASSESSMENT

Why We Are Doing This

We want to hear your thoughts on services to help children, families, and your community in the Kitchener-Waterloo-Cambridge Region.

Your Answers Are Private
Length: This survey will take you about 30 minutes to complete.

How your information will be used: We want to learn about the experiences of the whole community, not about the experiences of one person. When we share what we learned from this survey, we will show the overall results from everyone who participated in the Needs Assessment. Your answers will not be shared with anyone who is not part of the research team, and we will not share any information that can be used to identify who you are.

Your choice: Completing the survey is up to you. You can stop at any time and skip any question you don’t want to answer.

Data withdrawal: We will not be able to remove your answers after you complete the survey because we will not know which answers belong to you specifically.

Benefits and Risks
Benefits: Your input will help improve services at our organization.

Risks: Thinking about personal needs can feel challenging, upsetting, or overwhelming. You can stop or skip questions if you do not want to answer them. If you need support or help during or after participating in the survey, please let us know.

Questions or Concerns:

If you have any questions, please contact: Dr. Oluwakemi Aderibigbe (oluwakemi.aderibgibe@facswaterloo.org) or Leyco Wilson (leyco.wilson@facswaterloo.org)

Summary of the Report:

When the Needs Assessment is complete, we will share a report with all participants who ask to see the findings.

Compensation:

All participants who complete the survey will have a chance to win 1 of 3, $50 gift cards. If you want to be entered into the random draw, a link will be provided to you at the end of the survey where you can use to share your name and contact information (phone number or e-mail address). If you are the winner, we will contact you to let you know how you can claim the gift card.

Consent:

Do you consent to participating in the Needs Assessment Survey?(Required.)