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| How would you like to receive your surveys: * |
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| Gender: * |
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| Age: * |
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Tick if English spoken at home |
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| If not, what other language is spoken? |
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| What was the highest level of education you achieved? * |
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| If other, please specify: |
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| Please tick/check box if your business/organisation is a non-profit/non-government organisation (NGO): | |
| A business (private sector): | |
| A government organisation (local, state or federal): | |
| Other: | |
| Please describe: | |
| Please describe briefly your business/organisation structure (e.g. sole trader, partnership, trust, company, incorporated association, registered business name, family business etc), using all applicable descriptions:* | |
| What type of industry is your business in? * |
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| If other, please specify: |
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| Please tell us briefly why you decided to register for the study and receive the Business in Mind DVD and Resource Kit:* | |
Manager Consent Form
1. I have read and understood the 'Information Sheet' for this study.
2. The nature and possible effects of the study have been explained to me to my satisfaction in the information sheet and my consent is given voluntarily.
3. I understand that the study involves me:
- Completing a short survey 5 times over a 3 year period
- Being randomly allocated to receive one of 3 packages
- Receiving either:
- A DVD and accompanying Resource Kit that explores strategies for managing mental health issues in the workplace
- A different version of the DVD and Resource Kit that explores strategies for managing mental health issues in the workplace as well as ways to reduce stress and maintain a positive outlook on your work-life
- A DVD and Resource Kit PLUS 6 brief telephone calls to discuss this material (maximum 30 minutes each) that will take place over a three month period.
4. I understand that if I am assigned to the group receiving telephone calls, I will provide a telephone number and nominate a convenient time for these calls (can be after hours).
5. I understand that the study also involves me distributing an information sheet to my employees for them to consider participation in another aspect of this research but that I will not have any knowledge of whether they participate or not, or what their survey responses are.
6. I understand that all the information obtained in the study will be used for research purposes only and no information that could identify me will be published.
7. I understand that information collected via the surveys will be electronically stored on a secure server, or in a locked filling cabinet in Dr Angela Martin’s office at the University of Tasmania, and will be destroyed 5 years after the publication of the study.
8. I have been given the opportunity to ask the research team members any questions that I may have and if applicable, these have been answered to my satisfaction.
9. I agree to participate in this investigation and understand that I may withdraw at any time without prejudice.
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| I have read the above conditions to consent and voluntarily agree to participate in the study. (Please check/tick the box) * |
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