Ultra-Eye Study Questionnaire
You are invited to participate in a research study that is directed at learning more about the causes of visual problems during ultramarathons. You may participate in this study if you have ever had significant vision problems during an ultramarathon
The main purpose of the study is to determine the characteristics associated with visual
problems during an ultramarathon.
Your participation will involve completion of the following questionnaire. The questionnaire
will require about 10-15 minutes to complete.
You may reach the Investigator, Dr. Marty Hoffman, to discuss any questions or
concerns you have about this study at (916) 843-9027 or firstname.lastname@example.org. He is
associated with the VA Northern California Health Care System. If you have questions
regarding your rights as a research subject, or if problems arise which you do not feel
you can discuss with the Investigator, please contact the Institutional Review Board
Office at (916) 366-5359.
The information collected in this study will not be especially sensitive information, but we
will do our best to make sure that the information we gather will be kept private. However,
we cannot guarantee total privacy.
Your completion of the survey serves as your consent to participate in the study.
We very much appreciate your interest and participation in this study.
Marty Hoffman, MD
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