Consent Form - Survey

BANYAN COMMUNICATIONS CONSENT FORM

Please read and sign this sheet before you participate in survey

We’re pleased you have accepted our invitation to participate.

You will be responding to topics of interest to the Centers for Disease Control and Prevention (CDC). CDC engaged us to recruit for their survey.

Since your opinions, observations, reactions, and other expressions are the reason for conducting this focus group, we hope you will participate fully in the process. The risks of participating in the focus group will be minimal. You do not have to respond to any questions you don’t want to answer.

We will not sell, distribute, or otherwise release personally identifiable information we collect to CDC.

By proceeding to the survey, you acknowledge that you understand, agree to, and consent to the above.

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