Office of Disability Services
Lower Level of Memorial Union
620/341-6637 V; 620/341-6646 TTY

The Office of Disability Services supports the practice of protection for human subjects participating in survey materials and other research activities. The following information is provided so that you can determine if you wish to participate in the survey. If you choose to participate, you have the right to withdraw from the study at anytime without repercussions or other forms of reprimand.

The estimated amount of time to complete the survey is 5 minutes.

The information collected is for the purpose of assessing how the office is meeting its goals and objectives for the current year and how we can better serve students in the future. Your name will not be revealed as a participant or linked to the survey submitted to the office.

You can drop the completed questionnaire off at the office. Please detach this signed statement and include the statement below with your completed questionnaire. Thanks!!

I have read the above statement and have been fully advised of the procedures to be used in this project. I have been given sufficient opportunity to ask any questions I had concerning the procedures and possible risks involved. I understand the potential risks involved and I assume them voluntarily. I likewise understand that I can withdraw from the study at any time without being subjected to reproach.

____________________________________________    ______________
Subject                                                                                   Date

DS/Assessment/03-04

 

If accessing and completing the forms off campus, you will need to print this form off, as well as the survey, and either drop off the completed forms at the office or mail them to the Office of Disability Services, 1200 Commercial St., Box 4023, Emporia KS 66801. The forms can also be faxed to the office at 620/341-6640.

If you need accommodations to participate in the survey, please make requests to the director of the Office of Disability Services at 620/341-6637 V, 6646 TTY, or via email at disabser@emporia.edu

Survey

 

 

Last Updated March 22, 2007