CONSENT TO PARTICIPATE IN A RESEARCH STUDY
You have been invited to take part in a research study to
learn more about specific learning disability identification. This study will
be conducted by Karolina Nicewicz, School Psychology Department, College of
Liberal Arts and Sciences, St. John’s University, as part of her doctoral
dissertation. Her faculty sponsor is Dr. Dawn Flanagan, School Psychology
If you agree to be in this study, you will be asked to
participate in a one-time online survey. Participation in this study will
involve approximately 20 minutes of your time.
There is no risk involved. Although you will receive no
direct benefits, this research may help the field of school psychology in determining
the methods used in specific learning disability identification among school psychologists. You will not
be compensated for your time.
Any information about you will be written in such a way to
protect your confidentiality and the confidentiality of those around you. Your
name will not be used in this study to protect your right to privacy. Confidentiality
will be strictly maintained by keeping consent forms separate from data to make
sure that your name and identity will not become known or linked with any
information that you provide. Consent forms will be in a password protected
file. Responses will be deleted after the data have been analyzed.
No one will have access to any information about you except
for the principal investigator, Karolina Nicewicz.
Your participation in this study is completely voluntary. You
may refuse to participate or withdraw at any time without penalty. You have the
right to skip or not answer any questions you prefer not to answer.
If there is anything about the study or your participation
that is unclear to you or that you do not understand, if you have questions or
wish to report a research-related problem, you may contact Karolina Nicewicz at
firstname.lastname@example.org or Dr. Dawn Flanagan at email@example.com from the School Psychology Department at St. John’s University.
For questions about your rights as a research participant, you may also contact
the University’s Institutional Review Board, St. John’s University, Dr. Raymond
DiGiuseppe, Chair firstname.lastname@example.org,
718-990-1955, or Marie Nitopi, IRB Coordinator, email@example.com, 718-990-1440.
By agreeing to sign this consent form, you understand the
purpose, risks, and benefits of this research study.
If you select "Yes," you are agreeing to the terms and conditions of this research study.