CONSENT FORM
1) Title of Research Study: Names and Identity
2) Investigators: Richard Michalski, Ph.D. (Principal Investigator), Erin S. Lavender-Stott (Secondary Investigator)
3) Purpose: The purpose of this study is to collect information about naming practices and family relationships.
4) Procedures: To participate in the study you must be 18 years of age or older. Participants will be recruited through psychology courses to complete a survey online. Participants will be asked to complete the survey at home and in private. Participants will complete a survey about the origins of their names and various questions concerning their relationships with their family. This survey will take about 30 minutes to complete. The survey includes personal questions. 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 the confirmation page at the end of 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 the confirmation page.
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 students who do not meet the requirements for participation or who do not wish to participate, the investigators—in consultation with the instructor—will provide the students with an alternate assignment that can be completed for equivalent extra credit. Participants gain the benefit of knowing that they have contributed to our understanding of parental psychology and family relationships. Participants also will have the opportunity to learn more about their own family relationships.
7) Data Collection & Storage: All information provided will be kept confidential. No identifying information will be collected so responses provided by participants will remain confidential. Information collected is accessible only to the Principal Investigator. 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, Dr. 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.
