This survey is now closed. You may continue to preview the survey using the access code of 123456, but no data will be written to the survey database.

This survey will remain open through the third week of January -- please take the survey during the holiday break if you part of the random sample of selected students.

You may be part of a random sample of University of Toledo students selected to participate in a survey about health care and health insurance issues. Your response to this survey is important, even though you may not have used the Student Medical Center at the University of Toledo or be covered by the University's student health insurance program.

If you are part of the random sample of students selected to participate, we expect it will take you approximately 10 to 15 minutes to complete this survey. The survey includes questions about your use of health care providers and recent health care conditions requiring treatment. You may preview the survey by using the pseudo access code of 123456 or by downloading an Adobe Acrobat PDF copy of the survey at http://www.slba.com/toledosurvey.pdf.

The only inquiries you are required to answer are as follows: Demographic questions 1 through 13 pertaining to sex, age, ethnicity, country of citizenship, etc.; Question 18 pertaining to the number of visits you have had to the Student Medical Center in the past 12 months; and Question 33 pertaining to your primary source of health insurance. You are required to answer questions 18 and 33 because your answer to these questions determines which set of questions will follow (e.g., if you have had no visits to the Student Medical Center, you will be asked three non-user questions).

Other than the questions noted above, you may leave all other questions blank. When you click on the "submit" button at the bottom of each page, the survey software will call your attention to any questions you did not answer. You may then use the "back" button on your web browser to answer the question, or click on a "continue" button to bypass the questions you choose not to answer. If you inadvertently answer a question incorrectly, there is a button at the bottom of each page of the survey that allows you to clear all answers on that page.

Confidentiality and Your Options as a Survey Participant

You are invited to participate in this student survey as a result of a random selection of degree-seeking students at the University of Toledo who are eligible to use the Student Medical Center. This research project is being conducted by Stephen L. Beckley & Associates under contract to the University of Toledo and its Student Medical Center Review Committee. To participate, you will only need to complete the survey to which this web site is linked by clicking the button above/below labeled "click here to participate in the survey." There will be complete privacy of the information you supply, because your name will never be used or associated with the project. You are free to choose to participate or not participate, and you may stop your participation at any time prior to hitting the submit button at the bottom of page eight (simply close your web browser to discontinue your participation in the survey). Please note that you may also preview the survey using the pseudo access code number of 123456 (none of your answers will be recorded as you preview the survey).

Whether you participate or not will have no detrimental effect on your relationship with the University. By completing this survey you are giving your consent to participate in the project and you are certifying that you are over 18 years old.

We are doing everything possible to assure the confidentiality of the survey participants' responses. Although we have taken appropriate steps relative to survey data confidentiality, such as using a secure server, we cannot provide an absolute assurance that data transmitted over the Internet will remain secure. The use of the access code assigned to you for this survey is only used to reduce the possibility that students will take the survey more than once and to select the students for the prize drawings. Once you enter your access code, our survey program assigns a random number to the data string line for your answers. Thus, University of Toledo only knows if you have accessed the survey. We do not know if you have completed the survey after you have entered your personal six digit access code.

You may quit the survey anytime prior to moving to the comments section on page eight (i.e., answering the last question on page eight and clicking on "Okay, on to page nine") by either closing your web browser or hitting the back button on your browser to back out of the survey (no data will be recorded if you quit the survey before moving to page nine). If you discontinue the survey prior to completing page eight and later decide to complete the survey, you will have to contact Stephen L. Beckley & Associates (SLBA) to obtain a new survey access number. You may contact SLBA via email at beckley@slba.com or by calling toll free: 877-559-9800.

The aggregate survey data will be maintained on this web site after the completion of the survey. The aggregate survey data, however, will not be made available to any parties that are not approved by University of Toledo to receive survey data.

At the conclusion of the survey, you will be given the option to provide comments to Stephen L. Beckley & Associates (SLBA). Providing SLBA with any comments you may have about the survey is completely optional. Please do not use any identifying information (e.g. your name or phone number in the survey comments).

This survey was approved by the University of Toledo's Human Subjects Research Review Committee (HSRRC). If you have any concerns about your participation in this survey you may contact Dr. Gerald Sherman, Chairperson of HSRRC. Dr. Sherman may be reached by email at gsherma@utnet.utoledo.edu, by regular mail at Mail Stop 607, The University of Toledo, Ohio 43606-3390, or by telephone at 419-530-1918.

  This survey is now closed. You may continue to preview the survey using the access code of 123456, but no data will be written to the survey database.

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