Dr. Nancy L. Segal
Department of Psychology
800 N. State College Blvd.
CSUF, Room H830-M
Fullerton, CA 92834-6846

Twin Studies Center
(657) 278-2568

 

(657) 278-2142, 3514        Fax (657) 278-4843, 7134 nsegal@fullerton.edu
 

Survey: Loss of a Twin (Consent Form)

 

Thank you for participating in this study. The loss of a twin is an experience that deserves considerable professional attention. You are invited to participate in a study of how twin loss affects the surviving twin partner and other family members. Results from this study can teach us a great deal about how counselors and other psychological professionals may assist twins and their families in dealing with such loss. The public also needs to be informed about the unique aspects of twinship. You must be age 18 years, or older, to complete this survey.
 

If you decide to participate, you will asked to complete a survey that you will complete online. It is estimated that 30 minutes will be required for your participation. There are no foreseeable risks associated with this task. I am happy to share results with you when the study is completed, so one benefit to you would be learning more about how the findings impact the question under study.
 

Your participation is strictly voluntary. All research records will be kept confidential to the extent provided by law. Data are filed in cabinets and kept in a locked office to which only the investigator and assistants have access. In any written reports or publications, no one will be identified or identifiable, and only group data will be presented. The data will serve as the basis for a student project, and will later be used in conference presentations and journal articles. Data will be kept in a locked room indefinitely. Future uses of the ratings may include combining it with larger samples for other data analyses.
 

Your decision concerning whether or not to participate will not affect your future relations with California State University, or your relations with your current educational institution or place of business in any way. If you decide to participate, you are free to discontinue participation at any time.
 

If you have questions regarding your rights s a research participant, you may contact the Institutional Review Board (IRB) representative at CSUF, at 714-278-7640 who welcomes any questions. These forms and the data will remain on file indefinitely. You may also contact the investigator, Dr. Nancy L. Segal; please see the contact information in the letterhead.
 

Sincerely,
 

Nancy L. Segal, Ph.D.

Professor of Psychology

Director, Twin Studies Center

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You are making a decision about whether or not to participate. Proceeding with this survey indicates that you have read the information provided above and have decided to participate. You may withdraw at any time without prejudice after signing this form should you choose to discontinue participation in this study.