Purpose of Research
The purpose of this survey is
to assess coalition member perceptions regarding community
collaboration and the prevention and reduction of youth substance use in the
Town of Bennington, Vermont.
The potential benefits of
participating in this survey include, but are not limited to, influencing
development of coalition 12-month action plan goals, evoking change in
community collaboration practices, increasing coalition effectiveness and
strengthening the coalition structure.
The few potential risks (e.g.
potential for violation of privacy, stress from survey completion, legal
requirement to disclose information) to participating in this survey are
considered minimal, as survey questions will NOT ask for participants to report
personal behaviors and no names or other identifiable information will be
collected on completed surveys.
Your participation in this
survey is completely voluntary.
You may decide not to participate at all or may decide to stop
participation at any time. If you
have questions or concerns about this survey, if you want your rights as a
survey participant explained to you or if you want to revoke your consent to
participate in this survey, you may contact Kiah Morris, Director of the
Alliance for Community Transformations, at 802-442-0713 or at firstname.lastname@example.org,
at any time.
The information provided on
this survey will be kept confidential; confidentiality will be maintained to
the degree permitted by the technology used. Compliance with federal and state laws is mandatory and
requires certain types of information to be reported to the appropriate
survey is expected to require approximately 10 minutes of your time to complete.
By clicking NEXT, you affirm
that you are aged 18 years of age or older, have read and understand the above information, acknowledge that your
participation in this survey is completely voluntary and that you may choose
not to participate in this survey at all or at any time, and grant your consent
to participate in this survey, conducted for research purposes.