Father Visit Information Sheet

National Children’s Study

Visit Information Sheet

Father Visit

T hank you for participating in the National Children’s Study. When you joined the Study, we explained what it means to take part in this important research effort. This sheet gives more details about what we’d like to do during this visit.

What will happen during today’s visit?

1. During this visit, we would like to ask you some questions.

• We will ask you some questions about yourself, your health, your lifestyle, and where you live.

• You can decide what questions you want to answer. If you feel uncomfortable about any question, you can skip it.

• Today’s visit will take approximately 15 minutes to complete.

Are there any risks from today’s visit?

• Some of the questions we ask could make you feel uncomfortable. If you are uncomfortable, you can skip any part of the interview. You are in charge.

• Although we are taking many steps to protect your information, there is always a chance that your information or identity could be disclosed. We will continue to review and improve the ways we keep your information private. To protect your information, we will keep your name and address separate from our information files.

Are there any benefits from today’s visit?

• Taking part in the National Children’s Study may not help you or your family right now. But the Study may help us learn things about health that could benefit all of us—including your children and grandchildren—in the years to come.

Will I be paid for taking part in today’s visit?

• To thank you for your time, we will give you $25 for completing today’s visit.

What if I have questions about this visit?

• If you have any questions about this visit, you can ask the Study representative you are talking with today. If he or she cannot answer a question, we will give you the name and phone number of someone from our local office who can answer your questions.

Please remember:

• Whether or not you stay in the National Children’s Study is your choice. The alternative to taking part in the Study is not taking part in the Study.

• If you leave the Study, you can rejoin it later.

• If you leave the Study, we will not ask you for any new information, but we will keep using the information you have already given us. We will keep everything that you tell us confidential.

• Leaving the Study will not affect your access to health care or any other benefits you may be receiving, like those from Social Security, Medicaid, WIC, or the Supplemental Nutrition Assistance Program.

• If we learn that you or someone else is harming you, your child, or others around you, we may be required by law to report this to the police or a social services agency in your community.

• This is a research study and we cannot give you medical advice. None of the Study visits take the place of your regular doctor or clinic visits.

• We may contact you in the future to ask you to participate in other Study visits.

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