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Healthcare Access Survey

Informed Consent

Consent, Eligibility & Mode – Access and Attitudes towards Health Care by People with Disabilities

The Southwest ADA Center is carrying out research into the existing barriers to health care access by people with disabilities. As part of this research, we are asking adults (18+) with disabilities about their access and attitudes towards health care.

The information gathered from this survey will help us 1) understand the significant barriers to health care accessibility 2) explore how the socioeconomic status of the community influences health care access, and 3) determine how inaccessibility impacts attitudes and behaviour with respect to health care. These findings will also improve the trainings and technical assistance that the Southwest ADA Center can provide on this topic.

Whether you are able to access healthcare or not, we would like to hear from you. After the first question which confirms your eligibility for this survey, you can skip any question you prefer not to answer. The questionnaire will take approximately 15 minutes to complete.

This research study involves no foreseeable risk as no personal information will be collected. There is no cost and you will not be paid to take part in this study. The National Institute on Disability, Independent Living, and Rehabilitation Research, our funding agency, may review your answers but you will not be identified in the research. Once the study is completed, your answers will also be archived to a research database maintained by the Inter-university Consortium for Political and Social Research and may be used by other researchers.

Taking this survey is completely voluntary. You may withdraw at any time. Whether you participate or not will not affect your relationship with the Southwest ADA Center and the Memorial Hermann Health System.

This research project has been reviewed by the Committee for the Protection of Human Subjects (CPHS) of the University of Texas Health Science Center at Houston, HSC-MH-22-0538. For any questions about your rights as a research subject, please call CPHS at (713) 500-7943.

If you have any other questions about this research study, you may contact:

Vinh Nguyen
TIRR Memorial Hermann
1333 Moursund St
Houston, Texas 77030

By completing and submitting this survey, you consent to participate in this research study. Your signature is not required so that your answers can remain anonymous.

Thank you, your support and participation is very much appreciated,

Alexia Smalling