CONSENT FORM - Female Sexuality Survey

CONSENT FORM

1. Title of Research Study: Study of Female Sexuality and Orgasm

2. Investigator: Dr. Richard L. Michalski (Principal Investigator); Rose G. Bottle (Secondary Investigator)

3. Purpose: The purpose of this study is to collect information about women’s sexual behavior, specifically women’s orgasmic experiences.

4. Procedures: There are two criterion prospective participants must meet to be eligible to participate: (1) to participate in the current study participants must be a Female 18 years of age or older and (2) participants must have been involved in a romantic relationship. Participants will be recruited through classes to complete the survey in paper or online. Participants are asked to complete this survey in private, and without consulting others. Participants will complete a survey about various sexual experiences with their current, romantic partner. This survey will take about 45 minutes to complete. The survey includes personal questions that involve their sexual relationship with their partner. An example of one such personal question is “When was the last time you masturbated yourself to orgasm?” Participants will consent to participate by clicking the "I accept button" below. If participants are not eligible to participate, they should return stop and exit the survey. Participants should print out one copy of the confirmation page that appears after the survey for their records or for them to return to the instructor as proof of participation to receive extra credit. An alternative assignment will be made available if the participant should be unable or unwilling to take the survey.

5. Risks: Some of the questions may cause emotional upset. Participants may elect not to answer any question in the survey for any reason, and still receive credit for their participation, so long as the participant turns in a signed Consent Form (paper version of the survey) or Confirmation Page (online version of the survey).

6. Benefits: For participants recruited through classes, the Instructor of that course may offer extra credit towards that class for your participation in this study. If extra credit is offered, the amount of extra credit will be at the discretion of the Instructor. For participants who do not meet the requirements for participation or who do not wish to participate, the Investigator—in consultation with the Instructor—will provide the students with an alternate assignment that can be completed for equivalent extra credit. The purpose of this research is to acquire scientific knowledge about women’s sexual experiences with their romantic partners. Psychologists trained to incorporate knowledge gained through this study and others into treatment programs may be able to better identify methods of helping couples have healthier sex lives.

7. Data Collection & Storage: All information provided will be kept confidential. All responses are assigned a confidential number for coding purposes. If for any reason participants wish to withdraw from the study, may stop participation at any time without penalty. 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 contact the Principal Investigator, Dr. Richard Michalski, at (540) 362-6586 or through email at rmichalski@hollins.edu or the Secondary Investigator, Rose Bottle, through email at rbottle@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.