Feedback Form
Pioneering
Change to Promote Excellent Alternatives in
Kansas Nursing Homes
We would appreciate your assistance by completing this form. Responses will be used to shape future research. All responses will remain anonymous.
click here to view our informed consent statement
We hope that you will find this booklet helpful, and we at the PEAK-ED project in the Center on Aging at Kansas State University would appreciate your evaluation of it. This information will help us revise any future versions of the booklet and make modifications to the PEAK-ED web site. There are no foreseeable risks or immediate benefits to you. Your participation is voluntary, the responses you provide will be anonymous, and only summary data and analyses will be reported. Completing the questions should take approximately 5 minutes. If you have any questions about the evaluation, please contact Gayle Doll, Director, Center on Aging at 785-532-5945 or gerontology@ksu.edu. Should you have any questions or wish to discuss any aspect of the research with an official of the university you may contact Rick Scheidt, Chair, Committee on Research Involving Human Subjects, 1 Fairchild Hall, Kansas State University, Manhattan, KS 66506, (785) 532-3224. We appreciate the time you take to help us with the evaluation. Thank you!