Cover Page: Health care provider perspectives on penicillin/beta-lactam allergy: A North American survey |
Title: Health care provider perspectives on penicillin/beta-lactam allergy: A North American survey
You are invited to complete this survey because you are a physician, nurse practitioner or advanced practice registered nurse who prescribes in a pediatric or family practice setting in Canada or the United States. You are invited to complete this survey by the Principal Investigator, Dr. Tiffany Wong at BC Children’s Hospital. Questions about your information and this survey may be directed to the Principal Investigator:
Dr. Tiffany Wong
BC Children’s Hospital
4480 Oak Street
Vancouver, BC, V6H 3V4
604-875-2345 ext. 4934
tiffany.wong@cw.bc.ca
Your responses to this survey will be collected anonymously and we will not be able to identify you. Because the survey data is collected anonymously it will not be possible to withdraw your consent after you complete the survey. You do not have to participate. There will be no penalties if you do not want to participate. It will take 15 minutes to complete the survey. The survey will be closed on December 1, 2021.
Your personal information is protected by our privacy law in BC (called the Freedom of Information and Protection of Privacy Act (FIPPA)). For this survey, your identifiable information is collected under section 26 (e) of FIPPA. We will only use your information for the purposes listed on this form. In this survey you will be asked to share the following information for use by PHSA (Provincial Health Services Authority in BC, Canada):
- Personal views/opinions expressed in this survey.
- Career/practice information
We do not intend to identify you. For open ended responses, please do not share information that might identify you or someone else. When survey results are reported, presented, or published we will not include any data that could identify you.
Only the study team and the technical support team at BC Children’s Hospital will access your information. The study team will run the survey and analyze the results. Survey data will be stored in the BC Children’s Hospital Research Institute’s Secured Network electronically for 5 years. Published results will be available upon request at the end of the survey.
If you have any concerns or complaints about your rights as a research participant and/or your experiences while participating in this study, 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 (H20-03861) when contacting the Complaint Line so the staff can better assist you.