Questions marked with a * are required Exit Survey
Informed Consent Form
To: Research Participant
From: Heather Ford, Primary Researcher
You are invited to participate in this research study on the experience of emotions between dog owners and non-dog owners. I am a doctoral student at California Institute of Integral Studies (CIIS) in San Francisco. I am conducting a study to understand how dog owners and non-dog owners experience emotions. Taking part in this study will contribute to the exploration of the impact of dog and non-dog ownership. In addition, you will be helping the public become aware of ways in which owning a dog or not owning a dog can affect our experiences of emotion.
By being a participant in this study, you may learn something new about yourself and your emotions. Also, by participating you will be contributing to an understudied area of research on the emotional effects of dog ownership and non-dog ownership, which may lead to benefitting others.
Your involvement will include filling out some short surveys online, which should take a maximum of 15 minutes. You may be asked to participate in a confidential, one-on-one interview with the researcher that will last a maximum of 45 minutes to further explore your experiences. By completing the interview, you may gain a deeper understanding of your relationship with your dog or in relation to not owning a pet. The interview will be done over the phone or as a video conference call, not in-person. For video conference calls, you will be asked to find a quiet, secure, and confidential space to participate in the interview. The interview will be audio-recorded and transcribed.  
Your privacy is essential to this research. All information you provide will be completely confidential, and the questionnaires you fill out will be anonymous. Any records you provide will be assigned, a pseudonym (fake name) to protect your identification. All paperwork will be kept in a locked personal filing cabinet on private property, only accessible by the primary researcher. Surveys and transcripts will be stored on a personal hard drive with a password known only to the researcher and locked in a filing cabinet to which only the researcher holds the key, when not in use. Online data are collected on a secure, password-protected, website to which only the researcher has access. The website will only be accessed from a private, password-protected computer, and data transferred to a password-protected document; and after confirming that all the data records are accurate the website data are irrecoverably deleted. The interview will be conducted over the phone or as a video conference, through a secure password protected service. All audio-recordings will be password protected, and the transcriber and I will be the only individuals with access. The transcriber will be required to sign a confidentiality form and your identity will be concealed from the transcriptionist. I will alter any information that may identify you as a participant in this study and I will not use any identifying information in any public discussion or publication of the results from this study. All materials (paperwork and audio recordings) will safely be destroyed roughly one year after the study, unless requested otherwise by you. Pseudonyms will be used for all participants, and the index linking the real identities with the assigned codes will be stored in a locked box in a private location, in which only the researcher has access.
Your participation in this project does not guarantee direct benefits, nor is there any financial compensation for participating.
The risks involved are minimal. Since you will be answering questions about your life experience, it is possible they may stir up memories or uncomfortable feelings. If the interview becomes too much, we can pause for a rest or terminate moving forward.
Your participation is completely voluntary and you may withdraw from the study at any time without penalty or prejudice. You have the right to refuse to answer any question.
I, or the chair of my dissertation, can be contacted at any time throughout this study for questions or concerns.
            Name: Heather Ford, Doctoral Candidate           
            Email: hford@mymail.ciis.edu

Dissertation Chair:           
            Name: Jenny Wade, Ph.D.            
            Email: jwade@ciis.edu
This research has been reviewed and approved by the Human Research and Review Committee (HRRC) at the California Institute of Integral Studies for research involving human subjects. If you have any concerns or are dissatisfied at any time with any part of this study, you may report your concerns (anonymously, if you wish) to:
            California Institute of Integral Studies (CIIS)            
            Coordinator of the Human Research Review Committee            
            1453 Mission Street                
            San Francisco, CA 94103               
            hrrcoffice@ciis.edu (Email is the best way to contact the HRRC.) 
The results will be published through Proquest Dissertation Database in electronic form and will be accessible in hard copy through the CIIS library.
Bill of Rights

As a participant in a research study, you have the right:

1.     To be treated with dignity and respect.

2.     To be given a clear description of the purpose of the study and what is expected of you as a participant.

3.     To be told about the possible benefits of being in the study.

4.     To be told about the reasonably foreseeable risks of being in the study.

5.     To know the researcher’s training and experience.

6.     To ask any questions you may have about the study.

7.      To decide to participate or not without any pressure from the researcher or his or her assistants.

8.     To refuse to answer any research question, to refuse to be in the study at all, and to stop participating at any time without any negative effects to you.

9.     To be told whether there are any costs associated with being in the study and whether you will be compensated for participating in the study.

10.  To be told who will have access to information collected about you, and how your confidentiality will be protected.

11.  To be given a description of the overall results of the study upon request.

12.  To discuss any concerns or file a complaint about the study with the Human Research Review Committee, California Institute of Integral Studies, 1453 Mission Street, San Francisco, CA, 94103. hrrcoffice@ciis.edu
I attest that I have read and understand the consent form and the Bill of Rights. I am 18 years old or older. Any questions I have about this research study and my participation have been answered to my satisfaction. I understand that my participation is entirely voluntary and that no pressure has been applied to encourage participation. My signature indicates my willingness to participate in this research study and to have the results published. By clicking this box, I indicate my willingness to be a participant in this research.
* Participant Name
Check box to electronically sign this consent form
Check box if you have NOT completed this survey before
* Please mark your preferred method for the interview that lasts no more than 45 minutes, and provide email and phone number here:
Video Conference (Zoom)

* Email:
* Phone Number:
* Would you like a summary of the results?