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It is my understanding that this survey/questionnaire has been designed to gather information about the following subjects or topics: . . . . . I have been given some general information about this project and the types of questions I can expect to answer. I understand that the survey/questionnaire will be conducted in person/by phone/by email/on the internet and that it will take approximately ______ of my time to complete. I understand that my participation in this project is completely voluntary and that I am free to decline to participate, without consequence, at any time prior to or at any point during the activity. I understand that any information I provide will be kept confidential, used only for the purposes of completing this assignment, and will not be used in any way that can identify me. All survey/questionnaire responses, notes, and records will be kept in a secured environment. 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