Self-Administered Computerized Questionnaires on the WWW

Welcome to our study on self-administered computerized questionnaires on the WWW.

In this study we are investigating different options for the layout and design of questionnaires and surveys on the WWW. In this study you will be asked to fill out one or several surveys.

While we are not going to actually use the information that you enter, we would like for you to answer the questions accurately and truthfully so that we can tell how long it takes to think about the questions, recall the information from memory or look it up in files, and to generate the answers. Finally, you will be asked to fill out a final set of questions about the survey.

Information such as your name and social security number will always be treated with the highest of confidentiality and used only to confirm your credit for participating in the experiment.

Please read the following agreement and informed consent:

1.  I have freely volunteered to participate in this experiment (Computerization).

2.  I have been informed in advance as to what my tasks would be and what procedure would be followed.

3.  I have been given the opportunity to ask questions, and have had my questions answered to my satisfaction.

4.  I understand that there are no known risks to my participation of this research, and that this research is not designed to help me personally, but the investigator hopes to learn more about how people interface with the WWW.

5.  I am aware that I have the right at any time to withdraw consent and discontinue participation at any time, without prejudice.

6.  I understand that as renumeration for my participation I will recieve $10 upon completion of this activity.

7.  By selecting "Accept," I consent all of the above conditions.


Last Name: First Name:

Social Security Number:



Principal Investigator: Rod Stevenson
Phone Number: 301-405-5938

Faculty Member and Principal Investigator, have both accepted and consented to the terms of this form.