Participant's Rights
I have read and discussed the research description withe opportunity to ask questions about the purposes and procedures regarding this th the researcher. I have had
study.
My participation in the research is voluntary. I may refuse to participate or withdraw from participation at any time.
The researcher may withdraw me from the research at her professional discretion.
Any information derived from the research that personally identifies me will not
be voluntarily released or disclosed without my separate consent, except as specifically required by law.
If at any time I have questions regarding the research or my participation, I can
contact the researcher, Dave Rude who will answer my questions. The
researcher's phone number is (703) 899 - 6799 and email is:
[email protected] Marquardt, at (703) 726. I may also contact the researche- 3770. r's faculty advisor, Dr.
If at any time I have comments or concerns regarding the conduct of the research,
or questions about my rights as a research subject, I should contact the George
Washington University InstitutiStudent Services at (202) 994- 2715 onal Review Board through the Director, Doctoral or I can write to the IRB at 2030 M Street,
NW, Suite 301, Washington, DC, 20036.
I should receive a copy of this document.
Digital recording is part of this research. Onlytranscriptionist will have access to written and taped materials. Please check one: the principal researcher and the
( ) I consent to be audio taped.
( ) I DO NOT consent to be audio taped.
My signature indicates that I agree to participate in this study.
Participant's signature: Date: / /
Name (Please print):
Investigator's Verification of Explanation
I, David Rude, certify that I have carefully explained the purpose and nature or this
research to __(Participant's name). He has had the
opportunity to discuss it with me in detail. I have answered all his questions and he has
provided the affirmative agreement to participate in the research.
Researcher's signature: Date: / /
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