Harlow Thesis

* 1. You are being invited to take part in a research study by Katelyn Harlow, a graduate student in the Psychology Department at Abilene Christian University, under the supervision of Dr. Richard Beck, Chair of the Psychology Department at Abilene Christian University. Before participating, please take the time to read the following information carefully.

This survey is to determine if the presence of a chronically-ill family member increases the rate of empathy in a well-family member. If you volunteer to participate in this study, it should take less that 20 minutes to complete the surveys. You will be asked to complete the following surveys: (1) Family Demographic Assessment and (2) Empathy Assessment Index

Your participation in this research study is completely voluntary. It is your decision as to whether or not you complete the surveys and if you do choose to participate, you will be asked to sign a consent form. If you decide to participate in the research study, you are free to withdraw at any time and to not answer any questions you choose. There are no risks involved with this study nor are there any personal gains. There is no payment, personal gain, or any type of compensation for completing these questionnaires.

The records from this study will be kept as confidential as possible and personal identification (i.e. name) will not be used in any reports or publications that result from this study. I, the researcher, will make every effort to preserve your confidentiality by doing the following: (1) Assigning code numbers for participants; (2) Ensuring research information will be kept secure at all times. Only research personnel will have access to the research files.

If for any reason you wish to contact the researcher, please do so by E-mailing any questions or concerns to keh04d@acu.edu.

By choosing "yes" in this consent form, I confirm that I have read and understand the information. I understand that my participation is voluntary and withdrawal can occur at any time. I have the means to contact the researcher if any questions should arise.