Recording of physiological data Biological specimens Internet-based survey (provide location of Computer administered survey that is not online planned web site) Other, if other was checked, provide information about your method of recording participant responses in the box below. Identifying Participant Responses Mark an X next to the circumstance below that applies to your study (mark one): Anonymous, no participant identifiers will be collected (not at any point during the research) Indirect link to participant identifiers: Identifiers will permit an indirect link to participants (i.e., a code will be assigned to the data and a key linking the code to the identity of the participant exists somewhere, either temporarily or permanently) Indirect link to participant identifiers: Open-ended interview format or open-ended questions on a survey may unintentionally elicit indentifying participant responses (questions may elicit the names of individuals, places, events, objects that could identify an individual or group); this could also occur when investigating the doctor/patient or client/therapist relationship, a context where personal information may be inadvertently or unintentionally recorded Direct link to participant identifiers: Participant identifiers will be maintained with the data (i.e., personal or private information about the participants are associated with the data, either temporarily or permanently). In box directly below, explain and justify direct link to participant identifiers, state how long they will be kept. Other (explain in box below): If identifiers are collected, temporarily or permanently, include information about where identifiers will be kept, how long identifying information will be kept and when identifying information will be destroyed. Below, explain how open-ended data will be purged of any unintentional identifying information revealed (names of people, places, events, etc). Storage of Data and Privacy After Research Participation is Complete Will data be transported from a data collection site to the college or other location (in paper or electronic format)? Yes No If yes, in the box below, explain how the data will be transported in a way that protects the participants’ privacy: Data will be stored in which formats (mark an X next to all that apply): In electronic format (on a desktop computer or on a campus In paper format server) On a portable device (e.g., laptop, portable On the internet (off-campus server) hard drive) Other (explain in space below):
Recording of physiological data Biological specimens Internet-based survey (provide location of planned web site) Computer administered survey that is not online Other, if other was checked, provide information about your method of recording participant responses in the box below. Identifying Participant Responses Mark an X next to the circumstance below that applies to your study (mark one): Anonymous, no participant identifiers will be collected (not at any point during the research) Indirect link to participant identifiers: Identifiers will permit an indirect link to participants (i.e., a code will be assigned to the data and a key linking the code to the identity of the participant exists somewhere, either temporarily or permanently) Indirect link to participant identifiers: Open-ended interview format or open-ended questions on a survey may unintentionally elicit indentifying participant responses (questions may elicit the names of individuals, places, events, objects that could identify an individual or group); this could also occur when investigating the doctor/patient or client/therapist relationship, a context where personal information may be inadvertently or unintentionally recorded Direct link to participant identifiers: Participant identifiers will be maintained with the data (i.e., personal or private information about the participants are associated with the data, either temporarily or permanently). In box directly below, explain and justify direct link to participant identifiers, state how long they will be kept. Other (explain in box below): If identifiers are collected, temporarily or permanently, include information about where identifiers will be kept, how long identifying information will be kept and when identifying information will be destroyed. Below, explain how open-ended data will be purged of any unintentional identifying information revealed (names of people, places, events, etc). Storage of Data and Privacy After Research Participation is Complete Will data be transported from a data collection site to the college or other location (in paper or electronic format)? Yes No If yes, in the box below, explain how the data will be transported in a way that protects the participants’ privacy: Data will be stored in which formats (mark an X next to all that apply): In paper format In electronic format (on a desktop computer or on a campus server) On a portable device (e.g., laptop, portable hard drive) On the internet (off-campus server) Other (explain in space below):
ExemptApplicationrevised-August2013.docx