What You Need to Know to Participate
This document provides information to help you decide whether to join this research study. It is important you understand the responsibilities, risks and benefits of participating.
INFORMED CONSENT DOCUMENT AGREEMENT TO BE IN A RESEARCH STUDY
| Challenge/Study Title | A Quick Task to Complete |
|---|---|
| Challenge Coach (The Person in Charge of This Research Study) | Efforia Advanced Author |
| Sponsor | This study is made possible by your payment to join. |
| Challenge Cost | $0 |
| Included Products & Services | [Details to be provided] |
| Outcome Measures | [Details to be provided] |
| Contact | help@efforia.com |
The Purpose of This Study
This study is designed to explore how quickly and efficiently tasks can be completed under varying conditions. We aim to understand the factors that influence task performance and identify strategies that can enhance efficiency. Your participation will contribute to a broader understanding of productivity techniques. Insights from this study could help others optimize their task completion approaches.Your Responsibilities as a Participant
As a participant, you are expected to complete tasks as outlined by the study parameters. You should provide honest feedback and data concerning your performance and experience. Participants should engage with the study material regularly and report any issues promptly. Ideal participants are those willing to follow the study guidelines and contribute constructively to the research objectives.Your Rights as a Participant
Participation in this study is completely voluntary, and you can decide to withdraw at any time without any penalties. Please note that while you can leave the study at any point, the initial fee to join is non-refundable. This is to ensure the integrity and continuity of the study for all participants.How to Leave the Study
To leave the study, simply go to your Profile page, click "Your Challenges," and then select "leave." Remember, your join fee is non-refundable as it supports the study's operational integrity for remaining participants.Risks and Benefits
The primary benefit of participating in this study is gaining personal insights into your task completion strategies, which might enhance your productivity skills. While there are minimal risks involved, some tasks might challenge your comfort zone, which could lead to mild stress. It's important to manage these feelings appropriately and consult with a medical professional or life coach if they become overwhelming. In extreme cases, if participation leads to feelings of distress or suicidal thoughts, contact the National Suicide Prevention Hotline at 988 immediately.What to do if you have an adverse event or medical emergency
If you experience any severe adverse event or medical emergency during the study, seek immediate care from local health services. After receiving necessary medical attention, please report the event to help@efforia.com so we can take appropriate measures.Data Protections
Your data is essential to us! It will be collected strictly for study purposes and accessed only by authorized personnel. We'll use your data to send reminders and personalized reports via email, SMS, and push notifications. All data is securely stored on protected servers. By participating in this study publicly, you are encouraged to share your experiences using Efforia's features, enhancing both community knowledge and personal insight.If you have questions
Got questions? Dive into the community discussions! If you're more comfortable with private inquiries, reach out to help@efforia.com.California Experiential Research Subject’s Bill of Rights
As a participant in this study based in California, you are entitled to the California Experiential Research Subject’s Bill of Rights, which ensures your right to receive accurate information about the research, its purposes, procedures, risks, benefits, and the right to withdraw at any time.HIPAA Waiver
By agreeing to participate in this study, you acknowledge that certain health information may be used for research purposes only. This information will be handled in accordance with HIPAA regulations to ensure your privacy and data security. ```- Authorization and Consent for Diagnostic Testing
- I voluntarily consent and authorize CWI Physician Partners P.C., a California professional corporation; CWI Physician Partners P.C., a Hawaii professional corporation; CWI Physician Partners P.C., a Georgia professional corporation; CWI Physician Partners P.C., a Kansas professional corporation; CWI Physician Partners P.C., an Oregon professional corporation; CWI Physician Partners P.C., a Nevada professional corporation, CWI Physician Partners P.C., a Rhode Island professional corporation; CWI Physician Partners P.C., an Oklahoma professional corporation, as applicable ("CWI") to review the collection, testing, and analysis for the purposes of a diagnostic screening test. I understand that there are risks and benefits associated with undergoing a diagnostic screening testing and there may be a potential for false positive or false negative test results. I assume complete and full responsibility to take appropriate action with regards to my test results. Should I have questions or concerns regarding my results, or a worsening of my condition, I shall promptly seek advice and treatment from an appropriate medical provider. I further acknowledge the following:
- I am the individual who will provide the sample for the Test(s) that I am requesting or I am the parent or legal guardian of a minor who is providing the sample for testing.
- I am at least eighteen (18) years of age or I am the parent or legal guardian of a minor who is providing the sample for testing.
- I have read and understand the information provided about the Test(s) that I have been provided on the website where I requested the Test.
- The information I have provided in connection with my request to CWI is correct to the best of my knowledge. I will not hold CWI or its employees or agents responsible for any errors or omissions that I may have made in providing such information.
- My health information and results may be shared with CWI employees and agents for the purpose of ordering, processing, and reporting my results.
- Medical Services provided by CWI are purely for diagnostic assistance purposes and do not create a physician-patient relationship, and do not constitute medical care or diagnosis or treatment of any condition, disease, or illness.
- I authorize CWI to contact me via text message to communicate with me regarding my test.
- Patient Rights and Privacy Practices
- Notice of Privacy Practices and Patient Rights: CWI Notice of Privacy Practices describes how it may use and disclose your protected health information for other purposes that are permitted or required by law. To review a copy of CWI Notice of Privacy Practices, go to http://www.CynergyWellness.com.
- Disclosure to Government Authorities: I acknowledge and agree that my test results and associated information may be disclosed to appropriate county, state, federal, or other governmental and regulatory entities as may be permitted by law.
- Release
- To the fullest extent permitted by law, I hereby release, discharge and hold harmless, CWI, including, without limitation, any its respective officers, directors, employees, representatives and agents from any and all claims, liability, and damages, of whatever kind or nature, arising out of or in connection with any act or omission relating to my diagnostic test or the disclosure of my test results.
- By selecting the ACKNOWLEDGEMENT during the registration process for diagnostic testing, I acknowledge and agree that I have read, understand, and agreed to the statements contained within this form. I have read the contents of this form in its entirety and voluntarily consent to proceed with these procedures.