Terms of Research:
Thank you for taking the time to complete this survey on science, the environment, and mosquitoes.This form is part of an informed consent process for a research study and it will provide information that will help you decide what the study is about and what will happen in the course of the study. You are not giving up any of your legal rights by volunteering to take this survey or by agreeing to this consent form.
Participation in the survey will last approximately 15 minutes. The data collected will be used as part of broader study on community practices and pest control in West Baltimore. Data may be shared with colleagues through publication/ presentation. Please fill out the questionnaire to the best of your ability.
This research is anonymous. Anonymous means that I will record no information about you that could identify you. This means that I cannot record your name, address, phone numbers, date of birth, etc. If you agree to take part in the study, please know that no identifying information will accompany this form. There will be no way to link your responses back to you. Therefore, data collection is anonymous. All study data will be kept for three years.
You should know: There are no foreseeable risks to participation in this study. You have been told that the benefits of taking part in this study may be increased knowledge of scientific practices. However, you may receive no direct benefit from taking part in this study. Participation in this study is voluntary. You may choose not to participate, and you may withdraw at any time during the survey without any penalty to you. In addition, you may choose not to answer any questions with which you are uncomfortable.
If you have any questions about the study or study procedures, you may reach me by phone at (848) 932-5089 or by email at [email protected] or [email protected]. If you have any questions about your rights as a research subject, please contact an IRB Administrator at the Rutgers University, Arts and Sciences IRB:
Institutional Review Board
Rutgers University, the State University of New Jersey
Liberty Plaza / Suite 3200
335 George Street, 3rd Floor
New Brunswick, NJ 08901
Email: [email protected]
Phone:(732)235-9806
Thank you,
Baltimore Mosquito Project Team
Thank you for taking the time to complete this survey on science, the environment, and mosquitoes.This form is part of an informed consent process for a research study and it will provide information that will help you decide what the study is about and what will happen in the course of the study. You are not giving up any of your legal rights by volunteering to take this survey or by agreeing to this consent form.
Participation in the survey will last approximately 15 minutes. The data collected will be used as part of broader study on community practices and pest control in West Baltimore. Data may be shared with colleagues through publication/ presentation. Please fill out the questionnaire to the best of your ability.
This research is anonymous. Anonymous means that I will record no information about you that could identify you. This means that I cannot record your name, address, phone numbers, date of birth, etc. If you agree to take part in the study, please know that no identifying information will accompany this form. There will be no way to link your responses back to you. Therefore, data collection is anonymous. All study data will be kept for three years.
You should know: There are no foreseeable risks to participation in this study. You have been told that the benefits of taking part in this study may be increased knowledge of scientific practices. However, you may receive no direct benefit from taking part in this study. Participation in this study is voluntary. You may choose not to participate, and you may withdraw at any time during the survey without any penalty to you. In addition, you may choose not to answer any questions with which you are uncomfortable.
If you have any questions about the study or study procedures, you may reach me by phone at (848) 932-5089 or by email at [email protected] or [email protected]. If you have any questions about your rights as a research subject, please contact an IRB Administrator at the Rutgers University, Arts and Sciences IRB:
Institutional Review Board
Rutgers University, the State University of New Jersey
Liberty Plaza / Suite 3200
335 George Street, 3rd Floor
New Brunswick, NJ 08901
Email: [email protected]
Phone:(732)235-9806
Thank you,
Baltimore Mosquito Project Team
