Confidentiality and Consent Statement

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1. I understand that as a participant of the “Guide Dog Handlers Experience” survey, a study being conducted by CNIB under the direction of Dr. Mahadeo Sukhai, Diane Bergeron and Kristen Black, I am providing confidential information. All data collected will be kept anonymous and confidential. Results will be reported in aggregate, without any identifying features associated with any individual. Data will not be shared except in aggregate, summary form with outside parties.  (Required.)

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2. I also give permission for CNIB to have access to information I share during this project. I understand that I can terminate my participation in this survey at any time. (Required.)

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