Consent Script

CONSENT SCRIPT FOR DISCUSSION PROTOCOLS

INTRODUCTION (to be read aloud to the group)

Hello, my name is ___________ and I am accompanied by [INTRODUCE OTHERS IN THE ROOM AND THEIR ROLES]. Thank you for taking the time to talk today about how [FILL IN INSTALLATION NAME] approaches addressing harmful behavior of service members. I have questions for you about the installation environment and efforts to prevent and address self-directed harm like alcohol misuse, and behaviors that harm others, such as sexual assault, and domestic violence.

Our discussion today is part of an effort by the Office of Secretary of Defense to improve prevention efforts across the enterprise. Our team is from [FILL IN NAME OF ORGANIZATION] and we are here along with others from a range of Department of Defense Offices that focus on prevention including the Office of Force Resiliency, known as OFR, and the Sexual Assault Prevention and Response Office. [FILL IN BRIEF DESCRIPTION OF ORGANIZATION].

CONSENT (to be read aloud to the group)

Before we begin, I’d like to discuss the expectations for participation today. This is a standard statement, so it’s an opportunity for you to hear what we’re telling participants in each of the groups. I want to assure you that your answers will be held in strict confidence. [If more than one person in the room: However, there are others in the room so please do not share anything you do not want others to know.] While onsite we are having discussions with many service members and leaders and conducting a survey. We are also reviewing documents, data, and other information collected from your installation. Findings from across these sources will be reported in a memo to OFR to inform their future prevention planning. We will not report your responses individually and we will not name you specifically in any documents. We will be taking notes during all meetings, but they will not have your name on them. We request no discussion of open cases or investigations so as to respect the privacy of individuals who are not here to give consent to have their case discussed.

Your participation is voluntary. You may have been required to meet with us, but the degree to which you participate in the discussion and provide responses is your decision. Refusal to participate will involve no penalty or loss of benefits to which you are otherwise entitled. You may discontinue participation at any time without penalty or loss of benefits, to which you are otherwise entitled. If you have questions about your rights as a participant or need to report a participation-related injury or concern, you can contact [INSERT NAME OF APPROVING IRB] using the contact information provided to you in this information sheet. [HAND THEM THE CONTACT INFORMATION SHEET, IF POSSIBLE HAVE INSTALLATION SARC CONTACT ON THE SHEET AS WELL]

We are each walking into this room with different histories and life experiences. Given the topic of our discussion today, it is possible that our discussion could bring up difficult feelings for some of us. Please remember that you can step out of the room [or take breaks] at any time. Additionally, you have support personnel available to you [here at the installation/in the building] and we would encourage you to reach out to those personnel if you could benefit from that support. I appreciate you giving me the opportunity to take this moment before we get started to introduce myself and to remind you to do what you need to do to take care of yourself.

Any questions before we begin?

[Note if time with the participant is short, please focus on asking the questions in bold.]

--START—

--CLOSING—

Thank you very much for spending time with me today and answering my questions. The information you provided is extremely valuable and useful to us. Here is my contact information if you have any future questions or comments [PROVIDE BUSINESS CARDS AND PHONE NUMBER]. Thank you again and goodbye!