Waitlist - 03 - Consent Form - Focus Group - FINAL

Waitlist Data Management & Burden Improvement

Consent Form – Focus Group

Consent to Participate

You are invited to participate in a Department of Housing and Urban Development (HUD) customer experience discussion to share your valuable perspective on HUD-assisted housing and local waitlists for housing. Use this form to learn about this research and provide your consent to participate (if you choose to do so).

Overview

What is this project? HUD is exploring how they can support local partners and housing agencies to help improve the experience of individuals and families finding affordable housing through waitlists. To better understand customer needs, HUD is starting by talking to a variety of customers including, public housing agencies, housing providers, families, and others. We hope you will consider sharing your valuable feedback with HUD.

What will I be asked to do if I take part? We will ask you to set aside 1.5 hours to share your experience and perspective on housing waitlists in the form of a focus group with other participants providing their feedback at the same time.

Will you record what I say? Yes, this discussion will be recorded for note taking purposes only. Recordings will not be shared outside of the research team and will be deleted at the end of the project.

What are the benefits of participating? By taking part in this conversation, you will help HUD better serve people in the future. By participating, HUD can better understand the needs of the people it serves and to surface potential roles that HUD can play to improve experiences for customers in the waitlist system.

Will I receive money or another form of compensation for participating? You will not receive money or another form of compensation for participating in this conversation.

Will my identity be shared with other focus group participants? Your identity will be known to other focus group participants and the researcher(s) cannot guarantee that others in the group will respect the confidentiality of the group. We do ask that all participants agree to keep all comments made during the focus group confidential and not discuss what happened during the focus group outside the meeting.

Will you share my name? We will not use your real name in any of our materials. Your name will be stored temporarily in a secure location so we can schedule a conversation with you and will be deleted at the completion of the project. Only those responsible for scheduling and speaking with you will have access.

How will you use my feedback and how will that information be shared? The feedback you share with us will be disconnected from your identity and anonymized. We will sum up your feedback (along with other participants’ feedback) into research findings that will be shared. We respect your privacy and will never use your name in any reports. Additionally, we will avoid including details that might make it obvious that we are talking about you.

Will you share other personal information about me? Possibly. In any presentations, we may say “Charles (made-up name) is a man in his 30’s who lives in Texas.” We may also share details about your feedback about a government service. For example, “Charles finds it difficult to find information about benefits for people who’ve purchased cars that have tires that have been recalled.” We may share more than one detail about your experience from our conversation.

What are my rights as a participant in this conversation? Your participation is entirely voluntary. If at any time you do not feel comfortable answering a question as part of the conversation, simply say you’d like to move to the next question, and we’ll move on to the next question. If at any time you would like to end the conversation, you may do so.

What if I am unable to submit the consent online before our conversation? If for any reason you are unable to submit this form online, we will review the form verbally with you during our conversation and you will have the option to provide verbal consent.

Your consent

If you have questions, contact [name] at [email].

1. I have read the details about this project and have had my questions answered about participating in a focus group. I consent to take part in this feedback session. I consent to have this session recorded. I agree to have my quotes and feedback shared. I understand the name I provide will not be connected to any quotes or feedback. *

• Yes, I consent to take part in this feedback session and consent to be recorded

• No, I don’t consent to take part in this feedback session

2. I agree to keep all participants confidential and not share any comments made during the focus group and will not discuss what happened during the focus group outside of this meeting. *

• Yes, I agree to keep participants confidential and not discuss the focus group outside of this meeting

• No, I don’t agree to keep the discussion confidential

  

3. Please enter your name (this acts as your digital signature): *
   
   
   

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4. Please enter today’s date: *
   
   
   

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[Upon completing/submitting Microsoft Form]

Thanks!

Thank you for completing this consent form!

HUD Customer Experience | Draft – For discussion Purposes Only CX@HUD.gov 2