Focus Group Consent Form

Attachment 17

Research Consent Form – Focus Groups

Informed Consent – Focus Groups

Thank you for your interest in helping us test some materials for a study we are conducting for the Bureau of Justice Statistics (BJS). BJS collects data on the amount of crime and victimization that is occurring in the US. BJS collects this information with a survey, called the National Crime Victimization Survey (NCVS). Westat is assisting BJS in redesigning the NCVS. We are testing some new materials, letters and informational materials, that may or may not be included in a future redesign of this survey.

The whole point of this discussion is to obtain your reactions to the materials. There are no right or wrong answers – and we are interested in both positive and negative reactions.

Everything covered today will be treated as private: we will not share any information we obtain from you with anyone in a way that identifies who you are (for example, we won’t use your names in the report of the findings that we’ll be writing). We ask that you also not discuss our conversation outside of this group in order to respect the privacy of everyone in the group.

Behind me is a one way mirror. Behind it are some people I am working with on this project, from Westat as well as the agency we are working for. They came here today as well so that they can see and hear for themselves what you have to say.

Also, this discussion is being audio-taped – this is so that others who are interested in the results but could not be here today will be able to hear what you have to say. No one who is not directly involved in this research will listen to the recording. By signing this form you give your permission to be audio recorded.

Signature Date