“Web” / “Email” Consent to Participate in Research (confidential research)

Identification of Investigators & Purpose of Study 

You are being asked to participate in a research study conducted by the Multiple Chemical Sensitivities (MCS) Research team and Dr. Pam Gibson from James Madison University. The purpose of this study is to examine your perceptions regarding MCS or Environmental Sensitivities and any services and.or accommodations provided by any mental health providers, including psychologists, social workers, counselors, or psychiatrists. We do not view MCS as a psychological condition but rather are interested in the treatment that people with sensitivities receive from psychological providers.

Research Procedures

This study consists of an online survey that will be administered to individual participants through Qualtrics. You will be asked to answer questions related to MCS and services or accommodations provided for persons with MCS by mental health providers. Should you decide to participate in this research you may access the anonymous survey by clicking the next page button below.

Time Required

Participation in this study will require 20-30 minutes of your time. 

Risks

We do not perceive more than minimal risks from your involvement in this study.

Benefits

Potential benefits from participation in this study include helping Dr. Pam Gibson and the research team gain a better understanding of the services and accommodations available to persons with MCS as well as any needs that you have regarding providing services to this population.

Confidentiality

The results of this study will be submitted to conferences and journals for publication. While individual responses are anonymously obtained and recorded online through Qualtrics (a secure online survey tool). The data submitted via qualtrics will not be attached to an e-mail. The results of this project will be coded in such a way that the respondent’s identities will not be attached to the final form of this study. Aggregate data will be presented representing averages or generalizations about the responses as a whole. All data will be stored in a secure location accessible only to the researcher. Final aggregate results will be made available to participants upon request.

Participation & Withdrawal

Your participation is entirely voluntary. You are free to choose not to participate. Should you choose to participate, you can withdraw at any time without consequences of any kind. 

Questions about the Study

If you have questions or concerns during the time of your participation in this study, or after its completion or you would like to receive a copy of the final aggregate results of this study, please contact:

Dr. Pam Gibson                
Department of Psychology                
James Madison University            
gibsonpr@jmu.edu
(540) 568-6195



Questions about Your Rights as a Research Subject
David Cockley, Ph.D.
Chair, Institutional Review Board
James Madison University
(540) 568-2834
cocklede@jmu.edu

Giving of Consent
I have read this consent form and I understand what is being requested of me as a participant in this study.  I freely consent to participate. I certify that I am at least 18 years of age. By clicking on the next button, and completing and submitting this anonymous online survey, I am consenting to participate in this research.