ORD Informed Consent

VA ORD_Informed_Consent_Form (4).docx

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCA, VBA, VHA)

ORD Informed Consent

OMB: 2900-0770

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Focus Group Discussions: Concept Testing

Informed Consent Form


Booz Allen Hamilton, which has been contracted by the U.S. Department of Veterans Affairs (VA), invites you to share your opinions on concepts and messages for Veterans and their caregivers about VA research. The goal for this exercise is to refine the draft concepts and messages.


This discussion will last about 90 minutes. Researchers working on this project may also listen to and/or observe the discussion, and it will also be recorded.


The recordings and observations will be used to prepare a report for the VA. In the report, you will not be identified by name or any other personal information. Your participation and responses are voluntary, and your responses will not be shared with anyone but the researchers. The research poses no risks to you, and you can refuse to answer any questions or stop participating in the discussion at any time.


The Contractor will comply with additional safeguards for ensuring participant information is kept private to the extent permitted by law.  The last names of the participants will not appear on any focus group materials.  If we use quotes from the discussion in the final report, we will not identify the person who made the statement.


If you have questions about VA Research, you can find information on their Website at www.research.va.gov.



I have read the informed consent and understand my rights as a participant.



Print Name:___________________________


Signature:________________________________ Date:_____________


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleInformed Consent Form
Authorelevine
File Modified0000-00-00
File Created2021-01-31

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