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Arkansas Tech University
Emergency Management & Homeland Security
Informed Consent Statement

Project Statement:Getting People to Leave their Homes during a Hurricane
I invite you to participate in a web-based online survey that is completely anonymous. I am looking to reach all students, faculty, staff or anyone who is regularly living in a hurricane prone environment that have experienced a hurricane and have possibly left or stayed home during a hurricane.
The survey should take less than seven minutes to complete. 

Participation in this research project is voluntary:
This survey is completely voluntary on your part. There are no benefits from the survey once taken. Again, the survey is completely voluntary.

Your information will be kept confidential.
The web-based survey is administered through QuestionPro. QuestionPro does not collect or maintain any information that would identify who has taken the survey. Only the answers to the questions are recorded. There is no possible way for anyone to know what you answered to the answers on this survey. 

Statement of Risk:
There is no foreseeable risk other than the time it will take you to take this survey. 

Questions about the research study or this survey:
You may contact the graduate student, , directly by email [email protected] or the faculty thesis advisor Dr. Garner at [email protected] or the Department of Emergency Management at Arkansas Tech University at 479-356-2159.

QUESTIONS REGARDING YOUR RIGHTS AS A RESEARCH SUBJECT
THESE MAY BE DIRECTED TO DR. GARNER – ARKANSAS TECH UNIVERSITY: EMERGENCY MANAGEMENT DEPARTMENT
Email: [email protected]
By proceeding past this point in the survey, you are indicating that you consent to participation in this study. Please print out a copy of this consent form for your records.

Thank you,


Graduate Student
Arkansas Tech University
 
 
 
 
What is the reason for not leaving your home during an emergency?
 
Personal Items
 
My Pets
 
No Means of Transportation
 
Handicapped
 
 
 
Have you ever stayed in your home during the event of a hurricane?
 
Yes
 
No
 
 
 
On a scale of 1 to 10, with 10 being the Strongly Agree and 1 being Strongly disagree, what do you do think of a mandatory evacuation for an entire city?
 
1
 
2
 
3
 
4
 
5
 
6
 
7
 
8
 
9
 
10
 
 
 
What was one item that you lost during a hurricane that meant a lot to you?
   
 
 
 
Have you ever been to the nearest police station or city hall to gather information on hurricanes or hurricane evacuations?
 
yes
 
no
 
 
 
Tell me about the time you were in your home during a hurricane; were you scared?
   
 
 
 
What exactly are you wanting to get out of your local emergency management department?
   
 
 
 
Do you own a vehicle?
 
Yes
 
No
 
 
 
On a scale of 1 to 10, 10 being strongly agree and 1 being strongly disagree, how important is leaving your home during a hurricane?
 
1
 
2
 
3
 
4
 
5
 
6
 
7
 
8
 
9
 
10
 
 
 
How many pets do you own in your home?
 
1
 
2
 
3 or more
 
4 or more
 
 
 
Have you ever lost a loved one during a hurricane?
 
yes
 
No
 
 
 
On a scale from 1 to 10, with 10 being strongly agree and 1 being strongly disagree, how important is it that some agencies are able to force you out of your home if you refuse to leave during a hurricane?
 
1
 
2
 
3
 
4
 
5
 
6
 
7
 
8
 
9
 
10
 
 
 
What do you want to gain from your local law enforcement?
   
 
 
 
If someone came to your home and forced you to leave what would your response be? Please be mature and appropriate with your answer:
   
 
 
 
On a scale of 1 to 5, with 5 being strongly agree and 1 being strongly disagree, how important are personal items?
 
1
 
2
 
3
 
4
 
5
 
 
 
If you have ever heard of a hurricane preparedness guide what do you think of this document? If you have not read this document, why haven't you read this document?
   
 
 
 
Under what circumstance would you not leave during a hurricane evacuation?
   
 
 
 
Have you ever met with the city mayor or local town hall meetings to express your opinion on mandatory evacuations for your state/city?
 
yes
 
no
 
 
 
What are the questions that you would ask if you were to attend a local city hall meetings?
   
 
 
 
When was the last time you experienced a hurricane or hurricane evacuation?
 
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