The purpose of this form is to assure that you are given sufficient information to make an informed decision as to whether you will agree to be a subject in a study involving research.
We are currently conducting a study entitled “Psychometric Testing/Validation of Integrative Outcome Measurement Instrument” to measure the multidimensional configuration of an individual's level of wellness and quality of life. Your participation will involve one session for approximately 30 minutes. As a subject, you will be asked to complete an online health and wellness questionnaire.
The procedures in this study are not considered experimental. There are no more risks or discomforts associated with the procedures involved in this study than those ordinarily encountered in daily life or during the performance of routine physical or psychological examinations or tests. There may be no direct benefits to you for participating in this research, but your participation could be helpful in determining various lifestyle, demographic and other factors influencing human health and wellness.
Any information you provide during the course of the study will be recorded in such a way that your identity will remain confidential. This means that number codes will be used to record your information, no one but the researcher and the referring wellness provider will have access to the information, and it will be securely stored. Your identity will never be revealed and information about the study will be reported in group form only.
Your participation in this study is completely voluntary. If you choose to participate, you may change your mind at any time up to the submission of your questionnaire and withdraw your consent. You can withdraw by not completing or submitting the survey.
By accepting this informed consent I confirm that I understand the procedures to be employed in this study, all my questions concerning the study have been answered to my satisfaction, and I agree to be a subject in this study. I also agree to allow the researcher to present his or her findings publicly or privately, orally or in written form.