MOD Sandbox LA Puget Sound Consent Form (LA)

You are being asked to participate in a research study led by ICF and the University of California, Berkeley as part of the Independent Evaluation of the Federal Transit Administration’s Mobility on Demand (MOD) Sandbox Program. You were selected as a possible participant in this study because you have signed up to use VIA in Los Angeles or Puget Sound.

PURPOSE OF THE STUDY

Researchers at the University of California, Berkeley are conducting this research to gain information about your current travel behavior and use of public transit in Los Angeles (LA).

PROCEDURES

If you volunteer to participate in this study, we would ask you to complete the online survey. The survey should take  about 10 minutes to fill out. You must be 18 years or older to take this survey. By clicking [I agree to take this survey] you confirm that you are 18 years of age or older and consent to participate in this research.

POTENTIAL RISKS AND DISCOMFORTS

Some of the questions may make you uncomfortable. You may choose to not answer any questions that make you uncomfortable.

POTENTIAL BENEFITS TO SUBJECTS AND/OR TO SOCIETY

You may not directly benefit from your participation in this research. The results of the study will provide researchers with an understanding of how people use public transit in LA.

CONFIDENTIALITY

You will not be identified in this study, and no information that is obtained from this survey will be connected with you. Your confidentiality will be kept to the degree permitted by the technology being used. No guarantees can be made regarding the interception of data sent via the Internet by any third parties. Data may exist on backups or server logs beyond the timeframe of this research project.

IDENTIFICATION OF INVESTIGATORS

If you have any questions or concerns about the research, please feel free to contact Elliot Martin (survey-tsrc@berkeley.edu) at the Transportation Sustainability Research Center (TSRC), at the University of California Berkeley, Richmond Field Station, 1357 S.46th Street, Bldg. 452, Richmond, CA. 94804.

RIGHTS OF RESEARCH SUBJECTS

You may withdraw your consent at any time and discontinue participation without penalty. You are not waiving any legal rights because of your participation in this research study.

If you have questions regarding your rights as a research subject, contact the Office for Protection of Research Subjects at (510) 642-7461 or subjects@berkeley.edu. The office is located at 2150 Shattuck Avenue, Suite 313 University of California at Berkeley, Berkeley, CA. 947704-5940. The IRB Administration has also developed a website designed to make you familiar with your rights. The website discusses your basic rights as a research participant, an explanation of the informed consent process, the basic requirement that written consent be in a language understandable to you, and suggested sample questions to ask the research investigator regarding your participation in the study. This website can be accessed at: http://cphs.berkeley.edu