You are invited to participate in a research study about being a Stanford student. You will be asked to participate in a short interview.
There are no risks associated with this interview.
Please understand your participation is voluntary and you have the right to withdraw your consent or discontinue participation at any time without penalty or loss of benefits to which you are otherwise entitled. You have the right to refuse to answer particular questions. Your individual privacy will be maintained in all published and written data resulting from the study. I will provide you with my contact information if you have any questions for me about this study, or anything else. The card also has the contact information for the Human Subjects Office at Stanford if you have any questions about your rights as a participant.
Hand out a separate business card or contact sheet to subjects which includes the following contact information:
FOR QUESTIONS ABOUT THE STUDY
·
Appointment
Contact: If you need to change your appointment, please contact (insert name)
at (insert phone number).
·
Questions,
Concerns, or Complaints: *If you have any questions, concerns or complaints
about this research study, its procedures, risks and benefits, or
alternative courses of treatment, you should ask the Protocol Director. You may contact him/her now or later at (insert
name and phone number of Protocol Director).
·
Emergency
Contact: *If you feel you have been hurt
by being a part of this study, or need immediate assistance please contact (insert
name of Emergency Contact) at (insert Emergency Contact’s phone number)
or (if applicable) the Faculty Sponsor, (insert name of Faculty Sponsor)
at (insert Faculty Sponsor’s phone number).
·
Alternate
Contact If you cannot reach the Protocol Director, please contact (name) at (phone number and/or pager number).
·
Independent
of the Research Team Contact: *If you are not satisfied with the manner in
which this study is being conducted, or if you have any concerns, complaints,
or general questions about the research or your rights as a research study
subject, please contact the Stanford Institutional Review Board (IRB) to speak
to an informed individual who is independent of the research team at
(650)-723-2480 or toll free at 1-866-680-2906.
Or write the Stanford IRB, Administrative Panels Office,
OR if subjects are not English speaking:
Identify a local contact person to act as a liaison and translator for subjects who may want to contact the Human Subjects Office with questions or complaints. Include the following statement: "If you have questions about your rights as a study participant or are dissatisfied at any time with any aspect of this study, you may contact - anonymously, if you wish, (insert name and contact information for the designated liaison/translator), who will assist you in contacting Stanford’s Human Subjects Office."