WILFRID LAURIER UNIVERSITY

PSYCHOLOGY DEPARTMENT

INFORMED CONSENT STATEMENT

Families Database

Researchers: Dr. Pam Bryden, Dr. Michael Cinelli, Dr. Alexandra Gottardo, Dr. Jeffery Jones, Dr. Tobias Krettenauer,  and Dr. Eileen Wood

 

 

You are invited to participate in a research database. The purpose of the database is keep contact and demographic information about children and parents, in order for them to be contacted as potential participants in various research studies in Education, Kinesiology & Physical Education, and Psychology at Laurier.  Experiments may be related to language, cognitive, perceptual, mathematical, social, educational and motor performance in children and their parents’ behaviour across the lifespan. 

If interested in being a part of the Laurier Families database you will be asked to provide some basic information about yourself and your child(ren), along with contact information. 
 
Please read the following information carefully. We also suggest you print or save this form for your records.
 

Researchers Involved in the Database 

Dr. Pam Bryden, http://www.wlu.ca/homepage.php?grp_id=270&f_id=42
Dr. Michael Cinelli, http://www.wlu.ca/homepage.php?grp_id=2598&f_id=1
Dr. Alexandra Gottardo,  http://www.wlu.ca/homepage.php?f_id=1&grp_id=249
Dr. Jeffery Jones, http://www.wlu.ca/homepage.php?grp_id=262 
Dr. Tobias Krettenauer, http://http://www.wlu.ca/homepage.php?grp_id=2073&f_id=1
Dr. Eileen Wood, http://www.wlu.ca/homepage.php?grp_id=228&f_id=1


1. Database Administrator: Dr. Bryden is the main database administrator.  She may be reached at 519-884-0710 ext. 4213, pbryden@wlu.ca, if you have any questions about your involvement in the database. You may contact Dr. Robert Basso, Chair, University Research Ethics Board, Wilfrid Laurier University, (519) 884-1970, extension 5225 or rbasso@wlu.ca.

 
2. Confidentiality of your data? The information you provide for the database will be kept on a secure networked hard-drive at Laurier.  The drive is password protected, as is the file where your information will be kept.  Researchers listed on this form will be able to access the database in order to contact you about participating in one of their studies.  All researchers have signed a confidentiality agreement to safeguard your personal information.

3. Participation:  In agreeing to participate in this database you allow us to keep basic demographic information about yourself and your children, along with your contact information.  Periodically, you may be contacted to determine your interest in a study being conducted by one of the researchers named above.  All participation is on a volunteer basis.  You may withdraw from the database, and or have your data deleted, at any time by contacting the database administrator. Finally, you may refuse to answer any question(s) on this form that you do not wish to answer.

4. Questions? Please contact Dr. Bryden (519-884-0710 ext. 4213, pbryden@wlu.ca at any time if you have any questions about a study or wish to report any study-related problems.

 


CONSENT

I have read and understood the information presented above about the procedures and risks involved in participating in this database and have received satisfactory answers to my questions related to this database. I am aware that this database has been reviewed and received ethics clearance through the Research Ethics Board at Wilfrid Laurier University.  If you feel you have not been treated according to the descriptions in this form, or your rights as a participant in research have been violated during the course of this project, you may contact Dr. Robert Basso, Chair, University Research Ethics Board, Wilfrid Laurier University, (519) 884-1970, extension 5225 or rbasso@wlu.ca.  With full knowledge of all foregoing, I agree, of my own free will, to place my name and my child’s in the Laurier Families database.

 

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