CONSENT FORM
ASMGI Cybersecurity Industry Survey
INTRODUCTION
The purposes of this form are to give you information that may affect your decision whether to say YES or NO to participation in this research, and to record the consent of those who say YES.
RESEARCHER
Professor Scott Blough
Tiffin University
Office: McKillip
Phone: 419-448-3330
E-mail: bloughs@tiffin.edu
DESCRIPTION OF RESEARCH STUDY
If you decide to participate, then you will join a study involving research on your organization’s cyber security posture. This survey will take about 20 minutes of your time if you wish to participate.
RISKS AND BENEFITS
RISKS: If you decide to participate in this study, and if you asked about personal experiences and/or opinions– then you may face a risk of identifying negative thoughts or feelings related to unpleasant past/present experiences, so there is a remote chance that answering these questions might make you feel anxious or ill at ease. If this occurs, you may stop from participating at anytime without penalty. The researchers also will be willing to provide the names and contact information of a local counseling or substance abuse assessment and treatment services, (or on campus services), should you decide this would be helpful. Educational information can also be provided upon request.
Note: You or your medical insurance may be billed for this service. No other medical treatment or financial compensation for injury from participation in this project is available.
The researcher will try to reduce these risks by assuring the confidentiality of your responses, and by identifying any support services available in your area if needed, or by the ability to discontinue at any time. And, as with any research, there is some possibility that you may be subject to risks that have not yet been identified.
BENEFITS: The main benefit for participating in this study is increased knowledge of where in security the technology field is heading and what improvements companies are currently engaging in.
COSTS AND PAYMENTS
The researchers want your decision about participating in this study to be absolutely voluntary. The researchers are unable to give you any payment for participating in this study.
NEW INFORMATION
If the researchers find new information during this study that would reasonably change your decision about participating, then they will give it to you.
CONFIDENTIALITY
The researchers will take “reasonable” steps…to keep private information, such as questionnaires, confidential. The researcher will remove identifiers from the information and store information in a locked filing cabinet prior to its processing. The results of this study may be used in reports, presentations, and publications; but the researcher will not identify you. Confidentiality will be maintained to the limits of the law. Confidentiality may not be maintained if you indicate that you may do harm to yourself or are placing yourself in an immediate harmful situation—or if you may do/have done harm to others. In cases where one is thought to pose an imminent risk of harm, the appropriate health care providers and/or parents/guardians may be contacted.
All responses collected in this research will be analyzed in aggregate form, and no names will be linked to the analysis. Consent forms are separated and not linked to identifying information.
WITHDRAWAL PRIVILEGE
It is OK for you to say NO. Even if you say YES now, you are free to say NO later, and walk away or withdraw from the study at any time. Your decision will not affect your relationship with Tiffin University, or otherwise cause a loss of benefits to which you might otherwise be entitled. Taking part in this project is entirely up to you, and no one will hold it against you if you decide not to do it. If you do take part, you may stop at any time.
VOLUNTARY CONSENT
By agreeing to this form, you are saying several things. You are saying that you have read this form or have had it read to you, that you are satisfied that you understand this form, the research study, and its risks and benefits. The researchers should have answered any questions you may have had about the research. If you have any questions later on, then the researchers should be able to answer them:
If at any time you feel pressured to participate, or if you have any questions about your rights or this form, then you should call or email Professor Blough, at 419-448-3330 (bloughs@tiffin.edu) and he will assist you in any way possible.
By moving forward to the next section you are giving your consent to participate, but you can stop anytime.
INVESTIGATOR’S STATEMENT
I certify that I have explained to this subject the nature and purpose of this research, including benefits, risks, costs, and any experimental procedures. I have described the rights and protections afforded to human subjects and have done nothing to pressure, coerce, or falsely entice this subject into participating. I am aware of my obligations under state and federal laws, and promise compliance. I have answered the subject’s questions and have encouraged him/her to ask additional questions at any time during the course of this study. I have witnessed the above signature(s) on this consent form.
If you want to know more about this research project, please call the faculty researcher Professor Blough, at 419-448-3330. The project has been approved by Tiffin University. If you have questions about Tiffin University’s rules for research, please contact Dr. Jonathan Appel, Director, Institutional Review Board (IRB), Tiffin University (Tel. 419.448.3285 or email appelj@tiffin.edu).