PREtesting: No. to complete screener (assumes 50% eligible)

Animation in Direct-to-Consumer Advertising

Appendix A Animation Consent Form 070716

PREtesting: No. to complete screener (assumes 50% eligible)

OMB: 0910-0826

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Consent Form (Pretest and Main Study)
[CONSENT SCREEN 1]
You are one of about 2,000 people in the United States who are being asked to participate
in a survey about new consumer products. If you agree to take part in this research, you
will be asked to watch a TV ad about a consumer product and answer some questions about
the ad. The study will take about 25 minutes.
[CONSENT SCREEN 2]
This survey is being conducted by RTI International (RTI), an independent nonprofit
research organization. RTI is working with Research Now to conduct this survey but is not
affiliated with Research Now in any way. If you have questions about this survey, please
contact Member Services at http://www.e-rewards.com/contactus.do, and someone will
direct your questions to the appropriate researchers at RTI.
Possible Risks or Discomforts
There are no known risks to participating in this study. We do not expect that any of the
survey questions will make you uncomfortable or upset; however, if they do, you can refuse
to answer any question or you may take a break at any time during the survey.
Benefits
There is no direct benefit to you for participating. Your responses are very important
because they will help researchers understand how people make decisions about
medications.
Incentive
In appreciation for your time, you will receive $6.25 in e-Rewards currency.
Confidentiality
As with other surveys you receive from Research Now, the privacy and confidentiality of
your information is of the highest importance, and we are committed to maintaining a
secure environment in which you can participate. All information collected in this survey will
be kept confidential to the extent provided by law. Your name and your e-mail address will
not be shared outside of Research Now, and they will not be associated with your answers
or used in any report. The information obtained from all of the surveys will be combined into
a summary report so that details of individual questionnaires cannot be linked to a specific
participant.

Persons to Contact
If you have questions about the study, you can call the project director, Dr. Bridget Kelly, at
1-800-334-8571, ext. 22098 or the associate project director, Dr. Sarah Parvanta, at 1800-334-8571, ext. 26045. They can be reached between 9:00 AM and 5:00 PM Eastern
Time Monday to Friday.
If you have questions about your rights as a participant, you can call RTI’s Office of
Research Protection toll-free at 1-866-214-2043. Alternatively, you may contact Member
Services at http://www.e-rewards.com/contactus.do and indicate that you would like to
contact the RTI Office of Research Protection, someone will provide you with the appropriate
contact information.
[CONSENT SCREEN 3]
[RADIO]
[PROMPT IF SKIP]
[CONSENT1.] If you have read the previous screens and agree to participate, please click the
Yes button. If not, click the No button.




Yes, I agree to participate. [Continue with next section]
No, I do not agree to participate. [Go on to next question]

[RADIO]
[PROMPT IF SKIP]
[IF CONSENT1=NO OR SKIP]
[CONSENT2.] Are you sure you don't want to participate? Your opinions are important to us.
Please select the Yes button to continue this survey. Select the No button to exit.




Yes, I agree to participate. [Continue with next section]
No, I do not agree to participate. [End survey]


File Typeapplication/pdf
File TitleMicrosoft Word - Appendix A Animation Consent Form 070716.doc
AuthorDHC
File Modified2016-10-25
File Created2016-10-25

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