Information Sheet

Research on Evacuating Persons with Mobility Impairments

Engineering Laboratory

National Institute of Standards and Technology

BUILDING OCCUPANT INTERVIEW INFORMATION SHEET

You are being asked to participate in a study titled “Research on Evacuating Persons with Mobility Impairments” conducted by the Fire Research Division at the National Institute of Standards and Technology (NIST) within the Department of Commerce. NIST is performing a study on elevator usage in your federal building. The aim of this research effort is two-fold: 1) to understanding how building occupants with mobility impairments currently evacuate multi-story buildings in the United States during fire emergencies, and 2) to learn about concerns, if any, surrounding the use of elevators during fire evacuations. Your comments will provide guidance to designers and building managers on how to improve elevator design and usage during fire emergencies.

This study poses minimal risk to you. You may choose not to respond to any particular question. Although there are no direct benefits to you personally, your participation will provide invaluable information that will assist this study and related efforts to provide benefits to the nation in the form of improved life safety in the face of future building fire emergencies.

If you agree to take part in this study, the interview will be tape-recorded so that we can represent your experiences as accurately as possible. Please check one of the following:

I agree ___ do not agree ___ to be audio taped.

(If you do not wish to be audio taped, the Investigator will use hand-written notes only).

Your participation in this study is voluntary and without compensation. Also, you may refuse to answer any specific question raised during the interview. The interview audio and resulting transcript will be kept confidential to the extent permitted by law, including the Freedom of Information Act (FOIA) (5 U.S.C. 552) and the Privacy Act (5 U.S.C. 552a). Any information provided in interviews that will be used in reports resulting from this study, including personal quotations, will not release any personally identifiable information, for example, your name, phone number, and role in the building.

I have read this interview information sheet or it was read to me. I know that being in this study is voluntary. I choose to participate in this study. I have received, on the date signed, a copy of this document comprised of 1 page.

Name of Participant (printed): _______________________________________________

Signature ______________________________________ Date _________________

Please contact Kathryn Butler if you have any further questions about this study:

Kathryn Butler, Ph.D.
Fire Research Division/Engineering Laboratory
National Institute of Standards and Technology
100 Bureau Drive, Gaithersburg, Maryland 20899-8662
Phone: 301-975-6673

E-mail: [email protected]

NIST IRB Approved: _________________ 1