Consent to Participate Statement

University Affiliation: Clarion University of PA Administrative Office
108 Carrier Administration Building
Clarion, PA 16214
814-393-2337

Project Title: Laying the Foundation - Determining Health Care Knowledge and Interests of Parishioners of the Purpose and Functions of a Faith Community Ministry.

Principal Investigator:
Christina Weidle
413 East Bissell Ave.
Oil City, Pennsylvania 16301

Phone: 814.673.7073

Email: cweidle@clarion.edu

You are invited to participate in a research study being conducted through Clarion University. We ask that you read this form and ask any questions you may have before deciding whether you want to participate in the study.

Purpose of the Study:
The purpose of this study is to attempt to measure the participants knowledge of what a faith community program is and to identify future health care topics based on parishioners interests. The eventual plan is to initiate a faith-based health care ministry in our parish community.

Procedures:
If you agree to participate in this study, you will be asked to complete a survey in Campus Labs from Clarion University (approximately 30 to 35 minutes to complete). Completing the questionnaire is voluntary, and you may skip over any question(s) that make you feel uncomfortable.

You may withdraw from the study at any time. If you start the study and choose not to continue, you may exit out of the survey. If you complete the survey and choose not to continue the survey, please notify the principal investigator through email and your information will be removed from the survey.

Risks and Benefits of Being in the Study:
The study has the following risks of using your time to complete the survey. The benefits to participation are knowing that you participated in the research.

Compensation:
There is no compensation for participation.

Confidentiality:
All information will be handled confidentially to the extent provided by law so that no one will be able to identify you when results are reviewed. The records of this study will be kept in the Principal Investigator's office for three years.

Right to Refuse or End Participation:
I understand that I may refuse to participate in this study or withdraw at any time. I also know that I may be removed from the study at any time by the investigator.

Complaints or Concerns:
Please contact the Principal Investigator and/ or The Institutional Review Board at the Clarion University of Pennsylvania.
Clarion University of PA Administrative Office
108 Carrier Administration Building
Clarion, PA 16214
814-393-2337

Statement of Consent:
I have read the information described above. Participating by completing the questionnaire means that I have asked questions regarding the research study and have received answers to my satisfaction. I am 18 years of age or older and voluntarily consent to participate in this study.

Signatures will not be required as clicking on the next page of Campus Labs and completion of the questionnaire will indicate agreement to participate in this study.

Clarion University IRB Research Approval #:26-20-21

Thank you for your participation.