Preamble Statement
This survey is administered by [insert name(s) of research investigators and their institutional affiliations]. The purpose of the survey is to [explain in plain language why the survey is being conducted]. Information gathered during this survey will be written up as a [term paper, report, thesis, dissertation, book chapter, conference talk, scholarly journal article/paper etc.]. What we learn from this survey will help us understand [...].
To learn more about the survey and the researcher’s study, particularly in terms of any associated risks or harms associated with the survey, how confidentiality and anonymity will be handled, withdrawal procedures, incentives that are promised, how to obtain information about the survey’s results, how to find helpful resources should the survey make you uncomfortable or upset etc., please read the accompanying letter of information.
This survey should take approximately [X] minutes long to complete. People filling out this survey must be [identify an inclusion or exclusion criteria, e.g., 18 years of age or older].
You are free to complete this survey or not. If you have any concerns or questions about your rights as a participant or about the way the study is being conducted, please contact HIREB. The HIREB is responsible for ensuring that participants are informed of the risks associated with the research, and that participants are free to decide if participation is right for them. If you have any questions about your rights as a research participant, please call the Office of the Chair, Hamilton Integrated Research Ethics Board at 905.521.2100 x 42013.
]]>