Eligibility Screening Survey

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Eligibility Survey

Have you had experience working with or helping childhood cancer survivors (any type of cancer)?

* must provide value

Yes

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Survey consent

The research team at the BC Children's Hospital, PHSA studying Healthcare Providers and Educators role in school re-integration for Childhood and Adolescent Neuro-Oncology Survivors would like to ask you confidential questions in this survey to assess your eligibility for our research study. The goal of the research is to gain insight into the educational needs, challenges, and successes of childhood cancer survivors as they navigate their academic journeys. Your survey responses will assist us in determining your eligibility for participation and ensure comparable group characteristics for analysis. If you meet our study criteria, we will contact you to review the main study consent form and schedule the interview (if you are a healthcare professional) or focus group session (if you are a School Principal).

If you do the survey, you are consenting (agreeing) to participate. Completion of the survey is voluntary.

It will take no more than 10 minutes to complete the survey. The deadline to complete this survey is [ ].

We are asking you to share the following personal information:

1. Your profession

2. Your experience level

3. Your personal email address

* We would like to use your email address to communicate with you about this research study. Please note that some email services (e.g. Gmail, etc.) may store email contents, including personal information like your name and health information, outside of Canada, where privacy and security standards may be different. If you ever want to stop communicating by email or have any questions about this topic, please contact the project manager, Sara Izadi-Najafabadi at sizadi@bccrc.ca

Only the study team and the technical support team at the PHSA will access your information. The results of this survey are confidential. When results are reported, presented, or published the project team will remove any information that could identify you or anyone else. The team may use a quote from your comments if provided. Survey data will be stored securely at the BCCRI, PHSA for a minimum of 5 years after completion of the study. Collected data will be disposed in accordance with PHSA IMITS standards.

Federal and provincial privacy laws give safeguards for privacy, security, and authorized access to information. We will not give information that identifies you to anyone without your permission, except as required by law.

If you have questions about the survey or your information please contact: Sara Izadi-Najafabadi; address: 2^nd floor, 675 W 10^th Ave., Vancouver, BC, V5Z 1L3; phone number: 604-675-8065

If you have any concerns or complaints about your rights as a research participant, and/or your experiences while participating in this study, or if you have any privacy related complaints, contact the Research Participant Complaint Line in the University of British Columbia Office of Research Ethics by e-mail at RSIL@ors.ubc.ca or by phone at 604-822-8598 (Toll Free: 1-877-822-8598). Please reference the study number (H24-02660) when contacting the Complaint Line so the staff can better assist you.

Name of the individual providing consent (First & Last name):

* must provide value

Please enter your email address:

* must provide value

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.