Informed Consent
As part of a project for the Health Resources and Services Administration (HRSA), Crosby Marketing is conducting this interview to get your thoughts.
If you decide to be interviewed, here are some things you should know:
It is up to you to decide if you want to be interviewed.
Being interviewed should not harm you. You may not want to answer every question. You do not have to answer all the questions if you do not want to. If you would like more information about this, please let us know.
Your name will not be used in any reports. We will take notes. We may also audio-record the interview to make sure our notes are correct, but we do not keep these tapes once we have checked our notes.
You will receive money as a thank-you for taking the time to be interviewed.
You can stop the interview at any time, or not answer any question, and you still get the money for your time.
Being interviewed will not change any existing relationship you have with HRSA (for example, if you go to a HRSA clinic) or anything else about other Federal programs you may be in.
If you have any questions, please ask them now. If you think of a question later, please call the person listed below.
The interview will last approximately 1 hour.
Contact information: If you have any questions, please contact Mike Cosgrove at 301-951-9200.
Please sign to say that you understand this information and want to be interviewed.
Print your name: _________________________ Date: _________________________
Signature: _________________________
| File Type | application/msword |
| File Title | Informed Consent |
| Author | Christine Brittle |
| Last Modified By | RMaldonado |
| File Modified | 2012-01-26 |
| File Created | 2012-01-24 |