Dialysis Caregiver Survey

* 1. You are invited to participate in a survey conducted by Ride Connection, Inc.

What is the project about?
By listening to the stories of patients who receive kidney dialysis and their caregivers, Ride Connection hopes to learn how non-emergency medical transportation can be improved for patients with end-stage renal disease (ESRD). This planning study involves research including data collection using a focus group meeting, a survey and a planning workshop.

Why have I been asked to participate?
You are being asked to complete a survey because you are a caregiver for a person(s) with ESRD.

What can I expect if I decide to participate in the survey?
If you decide to complete the survey, you will be asked questions about your experience arranging, coordinating or providing transportation for a patient to and from dialysis treatment.

What are the risks and benefits of participating in the survey?
We do not anticipate any risks associated with your participation in this survey. Your participation will help improve non-emergency medical transportation for ESRD patients receiving dialysis treatment.

How will information collected during the study be used?
Information obtained through the survey will be recorded in a database. A written summary of combined responses will be prepared summarizing key themes that emerge from the survey. This is an anonymous survey: your name will not be collected in connection with your survey responses.

Voluntary Participation
Your participation in the survey is voluntary. You do not have to take part in the survey. Your participation in the survey is anonymous and will not affect your relationship with your clinic or your transportation provider.

If you have questions or concerns about your participation in this survey, contact Julie Wilcke at Ride Connection by email at jwilcke@rideconnection.org, or by phone at (503) 528-1737. If you have concerns about your rights as a research subject, please contact Office of Research Integrity of the PSU RSP, 1600 SW 4th Ave., Market Center Building, Ste. 620, Portland, OR; phone (503) 725-2227.

You may print a copy of this statement for your records.