Consent Screens

Women’s Reproductive Health Care Provider Survey (WRHCPS) Consent and Close
Screens
(As of 18 April 2023)

OMB # XX-XX-XXX
Expires: XX/XX/XXXX

Welcome to the Women’s Reproductive Health Care Provider Survey (WRHCPS)
The WRHCPS is the first time the Department of Defense (DoD) has surveyed Military Health
System (MHS) providers about their experiences with provision of women’s reproductive health
care. The results from this survey, along with those from a recent DoD survey of active-duty service
women’s (ADSW) reproductive health, will be used in scientific research to help DoD to improve
the health and readiness of female service members.
Please read the Privacy Advisory and informed consent statement that follows. Click the Frequently
Asked Questions (FAQs) button at the bottom of this page if you would like more details about the
study.
Before we begin, keep in mind that:
•
•
•

We recommend you take the survey in a setting where others will not be able to see your responses.
If you need to stop before you finish, you may use the weblink and your unique identification code
to restart the survey at the question where you stopped when it is convenient for you.
You may skip any question(s) for any reason. Your participation is completely voluntary.

PRIVACY ADVISORY
This survey is confidential. Only RAND and our survey partner, [TBD], will know who
participated in the study or who did not. Study staff have been trained to protect your individual
survey responses and are subject to civil penalties for violating your confidentiality.
The Defense Manpower Data Center (DMDC) has provided limited information about you (e.g.,
name, MOS, contact information) to allow the RAND Corporation to conduct this survey. To
reduce the length of the survey, RAND has also received demographic information about you such
as your service branch, pay grade, age, and education level from DMDC and will link it to your
survey responses. The data that RAND provides to DoD from the survey will be a reduced set of
responses, designed so that you cannot be identified from the data you provide. DoD has agreed to
these conditions to protect your privacy.
INFORMED CONSENT STATEMENT
Introduction: You are being asked to complete a confidential, voluntary DoD-approved survey.
Survey Contractors: DoD has contracted with the RAND Corporation to design and analyze the
Women’s Reproductive Health Care Provider Survey (WRHCPS). RAND is a private, nonprofit,
nonpartisan research organization. [TBD] another research organization, is collecting the survey data
for RAND.

1

Women’s Reproductive Health Care Provider Survey (WRHCPS) Consent and Close
Screens
(As of 18 April 2023)
Purpose: The purpose of this survey is to assess Military Health System (MHS) providers’
knowledge and experiences with respect to active-duty service women’s (ADSW) reproductive
health. The results will be used in scientific research to help DoD to improve the health and
readiness of female service members.
Selection: A random sample of MHS providers who could potentially provide service women’s
reproductive health care in the Air Force, Army, and Navy, have been invited to participate in this
survey. Note that these providers also provide care to ADSW in the Marine Corps and Space Force.
Flag officers (i.e., Admirals and Generals) were excluded from the sample.
Length: The survey will take approximately 20 minutes to complete.
Voluntary Participation: Your participation in this survey is voluntary. You may skip questions
you do not wish to answer and can stop participating at any point.
Confidentiality: The survey is confidential. We will not tell DoD, the Services, or your command
who did and did not complete the survey. Identifying information (e.g., names, military IDs) will not
be linked to survey data. Information you provide will be combined with that from other providers
to prepare statistical reports. At no time will your individual identifiable survey data be given to
anyone outside the study team. We will provide the DoD sponsor with a deidentified data set at the
completion of the study.
To help us protect your privacy, we have obtained a Certificate of Confidentiality from the National
Institutes of Health. The researchers can use this Certificate to legally refuse to disclose information
that may identify you in any federal, state, or local civil, criminal, administrative, legislative, or other
proceedings, for example, if there is a court subpoena. The researchers will use the Certificate to
resist any demands for information that would identify you.
Risks of Participation: Some of the questions asked are sensitive in nature. The survey asks about
the provision of care that may be at odds with your own personal beliefs. You may feel discomfort
or distress in answering one or more of these items. Therefore, we encourage you to take the survey
in private, where others will not see your computer screen.

2

Women’s Reproductive Health Care Provider Survey (WRHCPS) Consent and Close
Screens
(As of 18 April 2023)
QUESTIONS CONTACT SCREEN
Who do you contact if you have questions or concerns about the survey?
•
•
•
•

Questions about computer, technical, or survey problems: Contact the [TBD] Helpdesk’s tollfree number at 1-XXX-XXX-XXXX or by email at XXX@XXX
Questions about the overall study or RAND: Contact the RAND study team by email at
[email protected].
Questions about your rights as a participant in this study: Contact the RAND Human Subjects
Protection Committee at 1-866-697-5620 or by emailing [email protected]. If possible, reference
the study ID #2022-N0393.
Questions about the licensing of the survey: Information about DoD surveys can be found at
https://www.esd.whs.mil/Directives/collections/overview/; this survey’s OMB# is XX-XX-XXXX
and expiration date is XX/XX/XXXX.

(FREQUENTLY ASKED QUESTIONS) (hyperlink)
You can print a copy of this Informed Consent Statement by clicking the following button:
INFORMED CONSENT (hyperlink)
Click the Next button if you agree to participate in the survey.
NEXT (hyperlink)

3

Women’s Reproductive Health Care Provider Survey (WRHCPS) Consent and Close
Screens
(As of 18 April 2023)

4

Women’s Reproductive Health Care Provider Survey (WRHCPS) Consent and Close
Screens
(As of 18 April 2023)
You have finished the Women’s Reproductive Health Care Provider Survey (WRHCPS)!
Thank you for taking the time to complete this important survey. Your participation, and your
Service to our country, is greatly appreciated.
Due to DoD regulations, in order to receive compensation for completing the survey, you must
have completed the survey outside of duty hours. Please confirm that you completed this survey
outside of duty hours by clicking here [link to email confirmation screen].

5

Women’s Reproductive Health Care Provider Survey (WRHCPS) Consent and Close
Screens
(As of 18 April 2023)

6