Project Poop Scoop Consent Form
You are being asked to participate in a project conducted through Maryville University by Justin Broce, Maryville Senior Seminar student and Dr. Mark Cushman, Adjunct Instructor of psychology. This project is being conducted in partial fulfillment of the course requirements for Senior Seminar at Maryville University. Student candidates are learning to collect and assess data, so the results of the study may not be valid. However, the results, pending instructor discretion, will not be published or presented beyond the class. This course is in compliance with the Maryville University Institutional Review Board. The purpose of this research is to explore the psychological effects of animal-assisted therapy. If you agree to participate you will be asked to take part in a survey where you will be required to answer questions. The research will take about 20 minutes of your time. This project is not expected to involve risks of harm any greater than those ordinarily encountered in daily life. To better understand the relationship humans share with animals and its potential impact on psychological well-being. All of your responses will be anonymous and will be kept confidential. In addition, no individual data from this project will be shared. The group results of data from this study will be shared with members of the Senior Seminar course and the social science faculty of the College of Arts and Sciences. Pending instructor discretion, data may also be published or presented beyond the class. Your participation is voluntary and there is no penalty for your refusal to participate. You need not answer all questions and you are free to withdraw your consent and to discontinue your participation at any time. If you are a student, withdrawal will not affect your grade. In the event of your early withdrawal, any information that you have provided up to that time will be destroyed. If you have any questions regarding this study, or if any problems arise, you may contact the researcher, Justin Broce at jbroce1@live.maryville.edu or the supervising faculty member, Mark Cushman at mcushman@maryville.edu. You may also ask questions, state concerns regarding your rights as a research subject, or express any feelings of pressure to participate by contacting: Dr. Robert Bertolino, Chair of the Institutional Review Board at Maryville University, (314) 529-9659. Maryville University investigators and their colleagues who are conducting research recognize the importance of your contribution to the research studies, which are designed to improve educational learning environments. Maryville University investigators and their staffs will make every effort to minimize, control, and treat any complication that may arise as a result of this research. Maryville University recognizes its federally mandated responsibility to ensure that research be conducted in an ethical and scholarly manner, respecting the rights and welfare of all the human participants. Any research misconduct, including but not limited to fabrication, falsification, or plagiarism in proposing, performing and reviewing research, or in reporting research results; should be reported to Dr. Jennifer Brunworth, the Research Integrity Officer at (314) 529-9689. Advancing to the survey will signify your implied consent to participate. You are agreeing to participate in this study based on the information presented to you. You may choose to withdraw without prejudice or penalty. Please print a copy of this form which includes the name and phone number of the researcher and the IRB at Maryville University, should you have any questions. The protocol number on this consent form indicates that the project has been reviewed and approved by the Maryville University Institutional Review Board. Maryville University Institutional Review Board