Screening Survey IGNITE

 

The purpose of this screening survey is to see if you meet the criteria for taking part in our research study investigating Genetics of Autoimmune Encephalitis and related conditions. This survey will take approximately 2 minutes.

 

If you are eligible, our team will contact you soon to explain the next steps (how you will collect the sample(s), how you will ship it to us, etc.)

 

Information about you that you give during this survey will be kept as confidential as possible as required by law. It is possible that the Food and Drug Administration, and other federal and state authorities, may inspect this record.

 

Your participation in this research screening procedure is optional. If you refuse to answer the questions or stop answering them at any time, there will be no penalty, and you will not lose any benefits to which you otherwise would be entitled.

 

The risk to taking part in this interview is very small. The screening interview is not designed to ask you for sensitive personal information. If you qualify to take part in the study and are interested in taking part, then we will record your name and information; this will be kept confidential, but there is a small risk that people outside of the research team could learn this information. If you are not interested in the study, then we will destroy the personal information.

 

The benefit to you of taking part in this interview is that you will find out whether you can take part in study.

You will not be paid for answering questions in this interview since it is only to see whether you qualify to take part in the study.

If you have any questions, concerns, or complaints about this interview, contact Emmanuel Mignot at 650-723-5879. If you want to talk to someone separate from the research team about a concern or complaint or your rights as a possible research subject, please contact the Stanford Institutional Review Board (IRB) to speak to an informed person who is separate from the research team 1-866-680-2906.

 

Thank you for your interest in this study!

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