Introduce organization or researcher who is conducting survey. You are being asked to consider participation in a survey study because provide rational why individual or organization is selected to participate. This survey is being conducted to describe purpose of study/online evaluation, etc. Your feedback will be collected through completion of a survey (if applicable, a series of questionnaires) which will ask you a series of questions and should take about state time frame to complete. Your participation is completely voluntary. You may only answer the questions you feel comfortable answering. The risks of participating are low (Outline any possible risks which may arise. E.g. Loss of confidentiality, request to complete sensitive questions that may be upsetting, etc.). (If applicable- When responses are anonymous i.e. no way to link responses to individual) You are not required to provide any personal information such as your name, address or telephone number. Your responses will be anonymous as we will not know who has completed the survey or questionnaire(s) and it will not be linked to any information about you. (NOTE: if responses are coded or linked to possible identifying information or subsequent follow-up is request this must to be outlined). (If applicable, outline any Incentives for completion of the survey)– Upon completion of the survey you are eligible to receive a state what incentive. Please provide your name and mailing address on the separate page in the package in order to receive the state what incentive. . This information will be handled separately for the purposes of sending you the token of appreciation and will not be linked to study responses. Your participation (or feedback) is important to us and may help us describe how responses will be used. If you have any questions about this survey study, please do not hesitate to contact indicate name and title at indicate phone number or e-mail address. (If applicable, state funding source) The study is funded by the state name of funder. This and survey has been approved by the University of Manitoba Health Research Ethics Board. Completion and return of this survey implies your consent for the purposes stated above.
Introduce organization or researcher who is conducting survey. You are being asked to consider participation in a survey study because provide rational why individual or organization is selected to participate. This survey is being conducted to describe purpose of study/online evaluation, etc. Your feedback will be collected through completion of a survey (if applicable, a series of questionnaires) which will ask you a series of questions and should take about state time frame to complete. Your participation is completely voluntary. You may only answer the questions you feel comfortable answering. The risks of participating are low (Outline any possible risks which may arise. E.g. Loss of confidentiality, request to complete sensitive questions that may be upsetting, etc.). (If applicable- When responses are anonymous i.e. no way to link responses to individual) You are not required to provide any personal information such as your name, address or telephone number. Your responses will be anonymous as we will not know who has completed the survey or questionnaire(s) and it will not be linked to any information about you. (NOTE: if responses are coded or linked to possible identifying information or subsequent follow-up is request this must to be outlined). (If applicable, outline any Incentives for completion of the survey)– Upon completion of the survey you are eligible to receive a state what incentive. Please provide your name and mailing address on the separate page in the package in order to receive the state what incentive. . This information will be handled separately for the purposes of sending you the token of appreciation and will not be linked to study responses. Your participation (or feedback) is important to us and may help us describe how responses will be used. If you have any questions about this survey study, please do not hesitate to contact indicate name and title at indicate phone number or e-mail address. (If applicable, state funding source) The study is funded by the state name of funder. This and survey has been approved by the University of Manitoba Health Research Ethics Board. Completion and return of this survey implies your consent for the purposes stated above.
Basic_Elements_of_Consent_Disclosure_Statements_for_Survey_Research.docx