Family Voices Indiana shares this opportunity to share your voice:
You are invited to complete a survey about health issues with the goal of providing better information on the challenges faced by people with disabilities in Indiana in accessing health care. People with disabilities, their family members and disability advocates are being asked to provide information on their experience in accessing health care and sustaining a healthy lifestyle. This project is a collaborative effort between the Indiana Institute on Disability and Community at Indiana University – Bloomington, the Indiana Governor’s Council for People with Disabilities, and Indiana Protection and Advocacy Services (IPAS).
The Disability Poll should take you about 15 minutes to complete. You will be one of approximately 400-500 people who we hope will complete this poll. You can answer the questions online (http://thepollingplace.org) on a secure web site, or you can request the survey in an alternative format.
Your answers will be combined with others for all reports. Your participation in this poll is completely voluntary, and you may stop answering at any time.
The information collected from this survey will help us better understand the issues around health care access for people with disabilities in Indiana. Your responses will be used in the development of programs in Indiana communities to make life better for people with disabilities.
You will not be asked to identify yourself for this study and your answers will be anonymous. This means that we will not give out any information that identifies you. Your responses will be stored on a secure server (computer) at the Indiana Institute on Disability and Community. Only authorized research staff will have access to the information.
Your participation in this survey is voluntary. You may refuse to participate without penalty. You may also stop at any time without penalty and without loss of any benefits.
If you have questions about this survey or our procedures, you may contact David Mank, Ph.D., Principal Investigator, at the Indiana Institute on Disability and Community, Indiana University, 2853 E. 10th Street, Bloomington, IN 47408, or by e-mail at firstname.lastname@example.org or you may phone him at 812-855-6508.
For questions about your rights as a research participant or to discuss problems, complaints or concerns about a research study, or to obtain information, or offer input, contact the IU Human Subjects Office, located at 530 E Kirkwood Avenue, Suite 203, Bloomington, IN 47408, by calling (812) 856-4242 or (800) 696-2949, or by email at email@example.com.
By clicking on the link below, you agree to the terms stated above.