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Informed Consent Agreement
Please read this consent agreement carefully before you decide to participate in the study.
Purpose of the research study: The purpose of the study is to learn more about near-death experiences and their aftereffects.
What you will do in the study: You will be asked to complete questionnaires describing your experience and its effects, if any. These questionnaires will be mailed or e-mailed to you, and you may complete them in your home at your convenience. We may also wish to interview you in person to learn more about your experience and its effects. If that is the case, we will contact you to arrange a time and place that are convenient for you, and, if you agree, we may audiotape the interview.
Time required: The preliminary questionnaire usually takes between 30 and 60 minutes to complete, depending on how extensive your experience was and what you are able to recall of it. Depending on your responses to this questionnaire, we may send you further questionnaires from time to time, which would be of comparable length. If we should decide to interview you in person about your experience, that interview may also take about an hour.
Risks: There are no expected risks to your participation in this study.
Benefits: There are no direct benefits to you for participating in this research study. The study may help us understand near-death experiences and their effects on people’s lives.
Confidentiality: The information that you give in the study will be handled confidentially. Your information will be assigned a code number. The list connecting your name to this code will be kept in a locked file. When the study is completed and the data have been analyzed, this list will be destroyed. Your name will not be used in any report. If we audiotape an interview with you, we will erase the tape as soon as we have used it to make an accurate written account of the interview (usually within a month of the interview).
Voluntary participation: Your participation in the study is completely voluntary.
Right to withdraw from the study: You have the right to withdraw from the study at any time without penalty. If you do withdraw from the study, the information you have given us, including the audiotape if one was made, will be destroyed.
How to withdraw from the study: If you want to withdraw from the study, just tell us you no longer wish to participate. There is no penalty for withdrawing.
Payment: You will receive no payment for participating in the study.
If you have questions about the study, contact: Dr. Bruce Greyson, Division of Perceptual Studies, University of Virginia Health System, P.O. Box 800152, Charlottesville, VA 22908-0152. Phone: (434) 924-2281.
If you have questions about your rights in the study, contact:
Tonya R. Moon, Ph.D., Chair, Institutional Review Board for the Social and Behavioral Sciences, One Morton Drive Suite 500, University of Virginia, P.O. Box 800392, Charlottesville, VA 22908-0392; telephone: (434) 924-5999; e-mail: [email protected]; website: www.virginia.edu/vprgs/irb
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