PARTICIPANT'S RIGHTS
I have read and/or discussed the Research Description with the researcher. I have had the opportunity to ask questions about the purposes and procedures regarding the study or other entitlements.
• My participation in research is voluntary. I may refuse to participate or withdraw from participation at any time without jeopardy to my status as a client status or other entitlements.
• The researcher may withdraw me from the research at her professional discretion.
• If during the course of the study, significant new information that has been developed or becomes available which may be related to my willingness to continue to participate, the investigator will provide this information to me.
• Any information derived from the research project that personally identifies me will not be voluntarily released or disclosed without my separate consent, except as specifically required by law.
• If at any time I have any question regarding the research or my participation, I can contact the investigator, who will answer my questions. This investigator can be reached at Teachers College, Columbia University at 201-227-1343.
• If at any time I have comments, or concerns regarding the conduct of the research or questions about my rights as a research subject, I should contact the Teachers College, Columbia University Institutional Review Board/IRB. The phone number for the IRB is (212) 678-4105. Or, I can write to the IRB at Teachers College, Columbia University, 525 West 120th Street, New York, NY, 10027, Box 151. Or, I can contact the supervisor of this research, Dr. Barbara Wallace at Teachers College at (212) 678-3966.
• I should receive a copy of the Research Description and this Participant’s Rights document.
• If video and/or audio taping is part of this research, I ( ) consent to be audio/video taped. I ( ) do NOT consent to being video/audio taped. The written, video and/or audio taped materials will be viewed only by the principal investigator and members of the research team.
• Written, video and/or audio taped material ( ) may be viewed in an educational setting outside the research. The written, video, and/or audio taped material ( ) may NOT be viewed in an educational setting outside the research.
• My signature means that I am giving my permission to participate in this study.Participant’s signature:
Participant's ELECTRONIC assent: Yes I reviewed my Participant's Rights. Date: 02-06-2012 This ELECTRONIC assent keeps your identity confidential and anonymous, but allows you to proceed to the actual focus group.
