CONSENT  FORM

1)      Title of Research Study: Parental Relationships Survey

2)      Investigators: Richard Michalski (Principal Investigator)

3)      Purpose: The purpose of this study is to collect information about perceptions of parenting behaviors as well as other family relationships.

4)      Procedures: To participate in the current study you must meet two criteria: (1) you must be 18 years of age or older and (2) both of your biological parents must be alive. Participants will be recruited through classes at Hollins University. Participants recruited through classes will be asked to complete this survey at home, in private, and without consulting others and to return the materials at a scheduled time and location agreed upon by the Investigator and the Instructor. Participants will complete a survey about various perceptions of experiences in their family while they were growing up. This survey will take between 60 to 90 minutes to complete. The survey includes personal questions. For example, participants are asked to indicate on a scale from 0 (Never did this behavior) to 9 (Very frequently did this behavior) whether their parents swore or cursed at them while they were growing up. Participants will place the completed survey in a security envelope provided by the researcher, seal it, and then return it to Richard Michalski or a member of his research team. Participants completing the survey online will be asked to read and accept an online consent form before beginning the survey and if participating for extra credit in a course, will be asked to print out the confirmation page at the end of the procedure.

5)      Risks: Some of the questions may cause emotional upset. If your participation causes you upset you may elect not to answer any question for any reason.

6)      Benefits: The purpose of this research is to acquire scientific knowledge about perceptions of parenting behaviors. The current study expands on the literature on parenting by examining various types of parental investment in you. This study will add to this literature and can help clinicians treating parents for difficulties they have with their children or children who are victims of child abuse. Clinicians trained to incorporate knowledge gained through this study and others into treatment programs may be able to better identify methods of helping parents.

7)      Data Collection & Storage: All information provided will be kept confidential. Participants will place the completed survey in a sealed envelope along with a signed Consent Form. All research materials will be assigned a confidential number for coding purposes. Completed surveys and Consent Forms will be kept separate and in locked locations accessible only to Richard Michalski. Results will not be released or reported in any way that might allow for identification of individual participants. All information will be kept confidential, unless otherwise required by law. 

8)      Contact Information: For other questions about the study, you should call the Principal Investigator, Richard Michalski, at (540) 362-6586 or through email at rmichalski@hollins.edu.

9)      Consent Statement: I have read or had read to me the preceding information describing this study. All my questions have been answered to my satisfaction. I am 18 years of age or older and freely consent to participate. I understand that I am free to withdraw from the study at any time. I have received a copy of this consent form.