Date: October 31st 2004

INSTRUCTIONS for participation in this survey . . .

Consent
The purpose of this research study is to understand the health care information needs of the D/deaf and hard of hearing (D/d&hh) and communication problems that prevent the D/d&hh from using health care services. This project is being conducted for the Texas Association of the Deaf and will serve to advise hospital administrators about how they may better serve their D/d&hh patients. You are being asked to complete a survey that will take a total of about 1-2 hours, depending on the amount of information you wish to share.

Participation is voluntary and you may stop at any time. You give consent by completing the survey. No individual responses will be reported to anyone because data will be reported in aggregate.

Instructions
There are several sections to this interview as you will see below. To begin the survey, click on step #1 below, read each section carefully, and respond accordingly. At the beginning of each section, you will need to fill in your name and email address. It is not necessary that you fill in your whole name, just your first name and last initial will be fine, as this is only used to enable me to match up the various sections of the survey. Once you are finished, click on the "submit test" button at the bottom of the form. You may then proceed to the next step in this interview. It is important that you answer the survey questions as honestly and thoroughly as possible.

Terms
The term “health care services” or “services” is meant to include any type of medical services, such as physical exams, X-rays, blood tests, mammograms, pap smears, surgery, etc. It can also include complimentary, alternative, or holistic healing practices, such as acupuncture, massage therapy, etc. It can also include psychiatric services

PLEASE GO THIS LINK:
http://people.unt.edu/ske0001/DeafSurvey.htm and start survey online.

Thank you for your willingness to take part in this research--your help is greatly appreciated!!

For more information about survey, please contact Sandra Tyson at ske0001@unt.edu


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