Informed Consent to Survey – Volunteer Investigator: Big Brothers Big Sisters of London and Area, (519) 438-7065HiddenInvestigator:Big Brothers Big Sisters of London and Area, (519) 438-7065Purpose: I understand that the purpose of this data collection is to examine the benefits of being enrolled in BBBSOLA services on specific youth development areas (social skills, problem solving, and self-esteem for example) for youth engaged in our services, as well as to determine areas within the customer service of our organization that need improvement. HiddenPurpose:I understand that the purpose of this data collection is to examine the benefits of being enrolled in BBBSOLA services on specific youth development areas (social skills, problem solving, and self-esteem for example) for youth engaged in our services, as well as to determine areas within the customer service of our organization that need improvement.Duration and Location: I understand that I will be offered participation in voluntary surveys throughout the course of receiving services from BBBSOLA. These surveys may take from 5-15 minutes depending on the program and the individual. HiddenDuration and Location:I understand that I will be offered participation in voluntary surveys throughout the course of receiving services from BBBSOLA. These surveys may take from 5-15 minutes depending on the program and the individual.Procedures: I will be asked to answer questions about our social and psychological well-being, as well as questions about my feelings and opinions on the services that I have received from BBBSOLA. HiddenRisks/Discomforts:It has been explained to me that some of the interview questions may be considered somewhat personal and may cause some slight discomfort in answering them.Risks/Discomforts: It has been explained to me that some of the interview questions may be considered somewhat personal and may cause some slight discomfort in answering them. HiddenBenefits:I understand that the benefits from participating in this study may be to help BBBSOLA, and perhaps Big Brothers Big Sisters chapters across Canada, better understand the benefits of receiving BBBSOLA services, as well as the areas in which these services can improve.Benefits: I understand that the benefits from participating in this study may be to help BBBSOLA, and perhaps Big Brothers Big Sisters chapters across Canada, better understand the benefits of receiving BBBSOLA services, as well as the areas in which these services can improve. HiddenConfidentiality:I understand that a research code number will be used to identify my responses from those of other volunteers and that my name, address, and other identifying information will not be directly associated with any information obtained from me. A master listing of persons participating in the study will be kept in a database in a secure location, password protected, under lock and key, and only accessible by select staff. When results of this data collection are published or reported, my name or other identifying information will not be used.Confidentiality: I understand that a research code number will be used to identify my responses from those of other volunteers and that my name, address, and other identifying information will not be directly associated with any information obtained from me. A master listing of persons participating in the study will be kept in a database in a secure location, password protected, under lock and key, and only accessible by select staff. When results of this data collection are published or reported, my name or other identifying information will not be used. HiddenProcedures:I will be asked to answer questions about our social and psychological well-being, as well as questions about my feelings and opinions on the services that I have received from BBBSOLA.Right to Stop or End Participation: I understand that I do not have to take part in this data collection or complete any survey offered to me by BBBSOLA staff and that my refusal will not involve any penalty or loss of rights, nor will it affect the service that I receive from BBBSOLA in any way. HiddenSignatures:I have read this entire consent form and completely understand my rights with regard to collection of data from BBBSOLA. I voluntarily consent to participate in this research. I have been informed that I will receive a copy of this consent should questions arise.Signatures: I have read this entire consent form and completely understand my rights with regard to collection of data from BBBSOLA. I voluntarily consent to participate in this research. I have been informed that I will receive a copy of this consent should questions arise.HiddenRight to Stop or End Participation:I understand that I do not have to take part in this data collection or complete any survey offered to me by BBBSOLA staff and that my refusal will not involve any penalty or loss of rights, nor will it affect the service that I receive from BBBSOLA in any way.Volunteer Name(Required) First Last Signature of Volunteer(Required)Date(Required) MM slash DD slash YYYY Witness Name(Required) First Last Signature of Witness(Required)Date(Required) MM slash DD slash YYYY By clicking Submit I consent to the collection of this personal information in accordance with Big Brothers Big Sisters of London and Area's Privacy and Confidentiality Policy.HiddenConcent:I consent to the collection of this personal information in accordance with Big Brothers Big Sisters of London and Area's Privacy and Confidentiality Policy. Facebook Twitter Google+ LinkedIn
