Brand Lift Study for Soliciting Feedback for the Department of Labor Employment and Benefits Security Administration's integrated communications campaign

Department of Labor
Employment and Benefits Security Administration
Brand Lift Study
Consent Form

OMB Control No. 1225-0093 Expiration Date: 02/29/2027
Informed Consent for Research Participation:
Thanks for taking the time to complete the survey. Please read the statements below and sign
where indicated.
By submitting this form, you are indicating that you have read the description of the study and
that you agree to the terms as described.
If you have any questions, or would like a copy of this consent form, please contact
[email protected].
What this study is about
This survey is being conducted by the CMRignite on behalf of the Department of Labor,
Employment and Benefits Security Administration (EBSA). This survey is about enhancing the
information and resources provided by EBSA online and on its website. You were asked to
participate by DISQO, our partner.
Your Involvement in the Study
We will ask you a series of questions about your awareness of EBSA, awareness of various
rights related to job-based health benefit plans, and your opinions about the EBSA website.
The survey should take a maximum of 15 minutes total.
Your Participation is Voluntary
Participation is completely voluntary. You may refuse to answer any questions or end
participation at any time.
Confidentiality
We will take necessary and appropriate precautions to keep what you tell us confidential. We
may develop and present research reports that summarize the results of all the participants who
complete the survey. The reports are for internal use only. We will not use your real name in any
of our materials.
Storage of Personal Information and Session Data
We will securely store and process your personal information and session data until we deem

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the content no longer necessary for the research purposes outlined above. This data can
include your email address and phone number.
Statement of Consent
I have read the above information and received answers to any questions I have asked. I
consent to take part in this survey and to have any information I provide be used in the manner
described above. I understand that my name will not be used in connection with survey
responses. I expressly release CMRignite from and against any and all claims that I have or
may have for invasion of privacy, defamation, or any other cause of action arising out of the
production, distribution, display, or publication of the results of the project, so long as the
conditions of use described above are met.

o By clicking here, you agree to participate in this study

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