When I originally got the study approved I sent the moderator my questions and IRB form. I didn't want to clog up the site but here is what a person who would agree to an interview would see. Due to the nature of having a disorder (potentially stigmatizing) people do not have to sign my form, just verbally agree.
TITLE OF PROTOCOL: Living with Depression, Anxiety, and Other Mental Health Disorders
Please read this document carefully before you decide to participate in this study.
Purpose of the research study:
This study seeks to understand how depression, anxiety, and other mental health disorders affect people’s lives, and what health & coping strategies people turn to.
What you will be asked to do in this study:
In this study you are being asked to answer a set of questions. Depending on how the project progresses, you may be asked to participate in a real time interview over the phone or Internet chat.
We estimate it will take you 30 minutes to 1 hour to complete the survey, but the time required largely depends on the length of your answers.
Data exchanged over the Internet poses some security risks, but once your information has been received, it is password protected and we will associate your information with an alias. Your identity will be kept confidential to the extent provided by law. Any information identifying you will be kept in a secure location.
Potential Benefits and Anticipated Risk:
There is no financial compensation for this study. You may choose not to answer some questions or you may choose to end the session at any time. Please do skip any questions that potentially might cause you mental stress or you find too painful or personal. If as a result of participation you’d like to discuss anything with counselors or a mental health professional, we are not qualified to provide this service, but we can help you find someone who is.
Your participation in this study is completely voluntary. There is no penalty for not participating.
Right to withdraw from the study:
You have the right to withdraw from the study at any time without consequence.
Whom to contact if you have questions about this study:
Dr. Dana Fennell, Department of Anthropology & Sociology, University of Southern Mississippi, 118 College Drive #5074, Hattiesburg, MS 39406-0001, Phone: 601-266-5355, email@example.com
Whom to contact about your rights as a research participant in the study:
UFIRB Office, Box 112250, University of Florida, Gainesville, FL 32611-2250; ph 392-0433.
I have read the procedure described above. I voluntarily agree to participate in the procedure and I have received a copy of this description. My participation in the study serves as my acknowledgment of the above.