Tinnitus Survey
Thank you for beginning this survey! It is designed to gather information about tinnitus (the perception of a sound without an external source) before and during the COVID-19 pandemic. All information you provide will be de-identified; you will remain anonymous. You will be asked to give an email address at the beginning of the survey. Only Dr. Heather Malyuk will have this information and it will be kept confidential.
Informed Consent Information:
Purpose and Benefits
This consent letter informs you that the use of collected data and your interactions with Dr. Malyuk of Soundcheck Audiology is for educational and research purposes and may be shared with other researchers. This may include presentations and publications. Your data will be treated anonymously.
Risk, Stress or Discomfort
No stress or discomfort is involved if you choose to participate. There is minimal risk of breach of confidentiality but we will ensure that no personal identifiers are shared in presentations or written documents.
Other Information
You are free to withdraw your participation at any time without penalty or jeopardizing future care at Soundcheck Audiology or at any other facility. We appreciate your cooperation as we seek to improve hearing healthcare for the music industry. Please feel free to discuss this consent with Dr. Malyuk, at 330-807-6311 or by emailing heather@soundcheckaudiology.com.
Agreement for Voluntary Participation in the Study
The use of information from interactions with Soundcheck Audiology/Dr. Malyuk for research purposes has been explained to me and by reading this letter and choosing to participate in the study you recognize that you have had the opportunity to ask questions, you are not waiving any of legal rights, and should you decline participation at any point, you will still be entitled to receive services at Soundcheck Audiology without penalty or prejudice.
With kindest regards and gratefulness,
Heather Malyuk, AuD
Informed Consent Information:
Purpose and Benefits
This consent letter informs you that the use of collected data and your interactions with Dr. Malyuk of Soundcheck Audiology is for educational and research purposes and may be shared with other researchers. This may include presentations and publications. Your data will be treated anonymously.
Risk, Stress or Discomfort
No stress or discomfort is involved if you choose to participate. There is minimal risk of breach of confidentiality but we will ensure that no personal identifiers are shared in presentations or written documents.
Other Information
You are free to withdraw your participation at any time without penalty or jeopardizing future care at Soundcheck Audiology or at any other facility. We appreciate your cooperation as we seek to improve hearing healthcare for the music industry. Please feel free to discuss this consent with Dr. Malyuk, at 330-807-6311 or by emailing heather@soundcheckaudiology.com.
Agreement for Voluntary Participation in the Study
The use of information from interactions with Soundcheck Audiology/Dr. Malyuk for research purposes has been explained to me and by reading this letter and choosing to participate in the study you recognize that you have had the opportunity to ask questions, you are not waiving any of legal rights, and should you decline participation at any point, you will still be entitled to receive services at Soundcheck Audiology without penalty or prejudice.
With kindest regards and gratefulness,
Heather Malyuk, AuD