Before issuing a screener to potential participants, please include the following statement in writing (or verbally, if screening is done by phone or videoconference). Note that there are phrases in italics, and blank lines, where you will need to choose the most appropriate language and/or fill in the specific information for your study.
“Thank you for coming in today/your interest in the study. Before you officially enroll in this research study, I will be asking you to complete a questionnaire. It should take you no more than ___ minutes. This questionnaire is a screening tool that will ask you questions [about XYZ attributes] to determine your eligibility for participation in the study which involves ______.
If you are determined ineligible to participate, your completed questionnaire will be destroyed. If you are determined eligible to participate, the completed questionnaire will become part of the study materials, and we will protect your information as confidential and safeguard it from unauthorized disclosure. Only research personnel will have access to the information contained in your questionnaire.
If the questionnaire indicates that you are eligible to participate, we will proceed to obtaining your written informed consent for participation in the study. Do you have any questions?/Please contact the researchers at _____ with any questions.”