California State University, Fullerton
Research Study Consent Form
Research Study Consent Form
Study Title: Women’s Experiences with Dysmenorrhea
Protocol Number: HSR-23-24-246
Researchers: Dr. Aaron Goetz – Psychology Department Professor, Claudia Morris - Psychology Department M. A. Student, Haley Voegele - Psychology Department M. A. Student
You are being asked to take part in a research study carried out by Dr. Aaron Goetz, Claudia Morris, and Haley Voegele. This consent form explains the research study and your part in it if you decide to join the study. Please read the form carefully, taking as much time as you need. Ask the researcher to explain anything you don’t understand. You can decide not to join the study. If you join the study, you can change your mind later and leave the study at any time. There will be no penalty or loss of services or benefits if you decide not to participate in the study.
What is this study about?
The purpose of this research study is to understand how you feel physically and mentally throughout menstruation (including PMS).   
We also would like to know if you ever perceived sympathy from others because of your period cramps or other physical or emotional symptoms that originated from your period (menstruation) and have made it difficult for you to go about your day.
You are being asked to participate in this study because we’re interested in how you feel about your period and how sympathetic the people around you (partner, family, instructors, employers, etc.) are if you need extra time to deal with your period’s physical or mental side effects. Your responses will remain completely private.
You are asked to participate if you have or had a uterus and are 18 years old or older.   
You cannot take part in this study if you do not have nor ever had a uterus and if you are under 18 years old.
Taking part in the study will take about 15 – 25 minutes.
What will I be asked to do if I am in this study?
If you take part in the research study, you will be asked to fill out an online survey.
The survey will ask you about your overall experiences around the time of your period (menstruation), as well as how sympathetic you think people are about your period pain or other difficult experiences if you have any. You may refuse to answer any question in the questionnaire.
Are there any benefits to me if I am in this study?
Participants will be contributing to a new body of literature and experiencing the research process first-hand. In some cases, if you have not been familiar with the topic prior to the study, you may come away from the experience with a desire to learn more about perceptions of human behavior
Are there any risks to me if I am in this study?
There are no foreseeable risks from participating in this research.
Will my information be kept anonymous or confidential?
The data for this study will be collected anonymously. It is important to emphasize that the details submitted on the Google form (e.g., name and contact information) will be kept confidential and unlinked to the responses provided. In this survey, the anonymity of participants is ensured. Information will be stored in a password-protected computer at CSUF. No published results will identify you, and your name will not be associated with the findings. Under certain circumstances, information that identifies you may be released for internal and external reviews of this project. Only the researchers listed above will have access to the data.
The data for this study will be kept for 5 years after completion of the study. The results of this study may be published or presented at professional meetings, but the identities of all research participants will remain anonymous.
Are there any costs or payments for being in this study?
There will be no cost to you for taking part in this study.
You will be given the ability to enter an opportunity drawing for a $20 Amazon.com gift card even if you quit the study. If you wish to participate, you will be asked to kindly follow a link they will be provided to access a Google form that is completely separate from the Qualtrics survey, opening in a separate tab from the study. Participants will be informed that the details submitted on the Google form (e.g., name and contact information) will be kept confidential and unlinked to the responses provided in the survey, ensuring the anonymity of all participants.
If you are eligible for the 0.25 class credit. You will asked to click on a Google Forms link. This collecting minimal information is necessary for issuing the 0.25 class credit and the answers cannot be linked to your name.
Whom can I contact if I have questions?
If you have questions about this study or the information in this form, please contact the researcher Claudia Morris (cmorris12@csu.fullerton.edu), Haley Voegele (haleyvoegele@csu.fullerton.edu), or Dr. Aaron Goetz (agoetz@fullerton.edu).
If you have questions about your rights as a research participant or would like to report a concern or complaint about this study, please contact the Institutional Review Board at (657) 278-7719 or e-mail irb@fullerton.edu.
What are my rights as a research study volunteer?
Your participation in this research study is completely voluntary. You may choose not to be a part of this study. There will be no penalty for you if you choose not to take part. You may choose not to answer specific questions or to stop participating at any time.
What does my consent on this form mean?
Your consent on this form means that:
- You understand the information given to you in this form
- You have been able to ask the researcher questions and state any concerns
- The researcher has responded to your questions and concerns
- You believe you understand the research study and the potential benefits and risks that are involved.
I have carefully read and/or have had the terms used in this consent form and their significance explained to me. By clicking below, I agree that I am at least 18 years of age and agree to participate in this project. You may print this page for your records.