Dementia Pathways in Audiology Survey

Important Information

This survey asks about the current management of people living with dementia in UK audiology services.

You will have the chance to win a £50 voucher for taking part.

All information you provide will be strictly confidential and used only for the purposes of this study. You will not be identifiable in any reports or articles we prepare.

Please make sure to click 'NEXT' at the bottom of each page.

Participant Information Sheet

You can find more detailed information about the study in the Participant Information Sheet.

Please return to the survey using the back button on your web browser after reviewing the information sheet here:

https://static.onlinesurveys.ac.uk/media/account/171/survey/919765/question/DHL_Participant_Information_Sh_i085f7k.pdf

Consent Form

By submitting this form you are indicating that you have read the description of the study and that you agree to the terms as described.

If you have any questions about the research or the statements below, or would like a copy of this consent form, please contact eithne.heffernan1@nottingham.ac.uk

Please type your full name Required

Please tick each box to continue. Required

Please select exactly 6 answer(s).

I confirm that I have read and understand the Participant Information Sheet Version 3.0_28.09.2022 for the above study and have had the opportunity to ask questions.

I understand that my participation is voluntary and I can end the study at any time and withdraw my data by closing the browser.

I understand that relevant sections of my data collected in the study may be looked at by the research group and by other responsible individuals for monitoring and audit purposes. I give permission for these individuals to have access to these records and to collect, store, analyse and publish information obtained from my participation in this study. I understand that my personal details will be kept confidential.

I understand that anonymous direct quotes from the survey may be used in the study reports.

I understand that information about me recorded during the study will be made anonymous before it is stored. It will be uploaded into a secure database on a computer kept in a secure place. Data will be kept for 7 years after the study has ended and then destroyed.

I agree to take part in the above study.

Optional: I agree that my anonymous research data will be stored and used to support other research in the future, and shared with other researchers including those working outside the University. Required

Yes

Please click 'NEXT' below.

Name of Investigators: Helen Henshaw, Principal Research Fellow, Lead investigator and Emma Broome, Research Fellow, Principle-Investigator, and Eithne Heffernan, Senior Research Fellow.

School of Medicine, Mental Health and Clinical Neurosciences, Hearing Sciences, NIHR Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham NG1 5DU.

Dementia Pathways in Audiology Survey

Important Information

Participant Information Sheet

Consent Form

Name of Investigators: Helen Henshaw, Principal Research Fellow, Lead investigator and Emma Broome, Research Fellow, Principle-Investigator, and Eithne Heffernan, Senior Research Fellow.

School of Medicine, Mental Health and Clinical Neurosciences, Hearing Sciences, NIHR Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham NG1 5DU.

Title of Project: Developing strategic directions for Dementia and Hearing Loss research (Research Ethics Reference: FMHS 438-0122)

Electronic consent form WP1.1 Version 2.0 11.03.22