1. Consent Wavier

Doctoral Candidate: Sandip Kaur
Dissertation Chair/Principal Investigator: Dr. Clary Tepper

You are being asked to take part in a research study conducted by Sandip Kaur under the supervision of Dr. Clary Tepper from the Department of Psychology, California Northstate University. If you have any questions or concerns about this research, please feel free to contact Sandip Kaur at Sandip.kaur7530@cnsu.edu or Dr. Clary Tepper at clary.tepper@cnsu.edu. The results from this study will form the basis of a dissertation study.
 
Voluntary Participation:
Your participation in this study is voluntary. It is up to you to decide whether or not to take part in this study. If you decide to take part in this study, you will be asked to sign a consent form. After you sign the consent form, you are still free to withdraw at any time and without giving a reason. You can withdraw and/or exit the survey at any time without penalty. You may skip any question you do not wish to answer for any reason. If you withdraw from the study before data collection is completed, your data will be destroyed.

A. What of the purpose of the research?
      i. You are being asked to take part in this research study because you are a South Asian women in an intimate relationship. The purpose of this study is to gain a better understanding of relationship dynamics and stress encountered by South Asian women. The result of this study will also help guide future research directions for understating this topic.
B. What is experimental/new in this study?
      i. We will examine the responses provided by South Asian women on their questionnaire regarding their perceptions and experiences of being in an intimate relationship and its impact on their mental health.
C. What do I have to do in this research?
      i. If you choose to participant in this study, you will be asked to complete a questionnaire that ask questions about common relationship stress encountered by South Asian women, and impact of stress on your mental health. The questionnaire will likely take you 30 minute to complete.
D. What could go wrong?
      i. Risks associated with this study are minimal. You may feel uncomfortable with questions that ask about sensitive topics, such as impact of relationship distress on your ability to do certain tasks and impact on your mental health. You have the right to skip questions or discontinue the questionnaire to minimize your discomfort.
E. What are the benefits?
      i. This study may provide a greater understanding of common relationship distress encountered by South Asian women and the impact the relationship distress can have on South Asian women. This may help develop future interventions on how to approach relationship distress encountered by South Asian women and how to approach unique cultural factors associated with intimate partnership within the South Asian comm
Nature and Purpose of the Study
The purpose of this study is to examine the intimate relationship distress that South Asian women can encounter.

Procedures
If you volunteer to participate in this study, we will ask you to answer a short online questionnaire. First you will be asked indicate your agreement. Then, if you consent to take part in the study, you will be asked to answer 30 short questions. The questionnaire should take minimum of 20 to 30 minutes to complete. Once completing the questionnaire, then you can safely exit the website. Any information that is collected as part of the research will not be used or shared with other researchers for future research studies.
Discomforts and Risks

Risks associated with psychological assessments:
Some of the questions we will ask you as part of this study may make you uncomfortable as they surround some sensitive topics. You may refuse to answer any questions or take a break at any time. You may stop your participation in this study at any time.

Risks associated with confidentiality:
As with any research, there is a potential risk of loss of confidentiality. Every effort will be made to keep your information confidential; however, this cannot be guaranteed.

Benefits

You will not receive any direct benefit from your participation in this study. We hope that the information obtained from this study on how relationship stress impacts South Asian women and may help inform the development of future interventions for South Asian women experiencing relationship stress and mental health issues due to relationship distress.

Alternative Therapies
There is no treatment in this study.
Refusal/Withdrawal
It is up to you to decide whether or not to take part in this study. If you decide to take part in this study, you will be asked indicate your willingness continue. After you agree to continue, you are still free to withdraw at any time and without giving a reason. You can withdraw and/or exit the survey at any time without penalty. You may skip any question you do not wish to answer for any reason.

You will not experience any consequences if you choose to withdraw from the study. If you choose to withdraw, any data collected up to that point will be destroyed or stripped from data files. If you decide to quit the study and have any questions, please contact the doctoral candidate researcher Sandip Kaur at (530) 593-1433 or Sandip.kaur7530@cnsu.edu.
Rights and Complaints
If you have questions about this study, you may contact the principal investigator, Dr. Clary Tepper at clary.tepper@cnsu.edu or doctoral candidate researcher, Sandip Kaur, M.A. at Sandip.kaur7530@cnsu.edu. If you have any questions about your rights, please contact Katherine Whitcome, PhD., IRB Chair at Katherine.whitcome@cnsu.edu, or (916) 686 8533.

Confidentiality
Your anonymous responses will be collected through Survey Monkey and forwarded to us. No identifiable information will be collected. Your responses will be download to a secure file that requires a password to access. Only doctoral candidate researcher and dissertation chair will have access to the password. Responses will be deleted from the file after analysis is complete and study findings are professionally presented or published. No information that can identify you will appear in any professional presentation or publication. The information collected about you for this research will not be used by or distributed to investigators for other research.

Question Title

* 1. Participant Agreement
I have read this informed consent and authorization form. ALL OF MY QUESTIONS HAVE BEEN ANSWERED, AND I WANT TO TAKE PART IN THIS RESEARCH STUDY. By clicking agree below, I give my permission to participate in this research study and for the described uses and releases of information.

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