Research panel consent statement

Please complete this questionnaire if you are interested in joining the Action on Hearing Loss Research Panel.
 
We use our research panel to carry out regular research projects to support our work. The information that we get from our panel members is used to inform and influence our work. We may also, on occasion, distribute relevant surveys on behalf of other organisations that we work with.
 
It is important that our research panel includes a diverse range of people with deafness, hearing loss and tinnitus. To understand who is applying to our panel, this survey asks a range of questions, including information about your hearing loss and ethnicity.

You do not have to answer every question, but the more details that you can provide, the better informed we will be about the panel. We will use the information to identify where we might need to do further work to recruit particular groups of people. We might also use this information to help us select groups of people where research topics may be of interest to them. By answering these questions you are consenting to us using your data in this way.  

Panel members are contacted by email about research opportunities and can chose which projects they participate in. We also contact panel members to share research findings, update on projects and share information on how evidence from the panel is shaping our work. We use a third party email provider, further information is available in our Privacy Policy, via the link below.

In order to run our Research Panel, we use SurveyMonkey to conduct our surveys, including this sign-up survey. Any data collected through SurveyMonkey may be transferred outside of the EU, but will be kept securely and only used for the purposes outlined. Further information can be found in SurveyMonkey’s Privacy Policy
 
We will hold your personal data while you are active on the panel and for two years after you last complete a survey.

By completing each question in this survey you consent to us using this information as described above. You can choose which questions you answer and do not have to answer every question.

By providing your email address you consent to us contacting you by email as described above.

You have the right to withdraw your consent for us to hold and use your information for the purposes of the research panel at any time. If you no longer wish to take part in our research panel, please contact us at panel@hearingloss.org.uk and we will remove your details from our panel database. Please use this email address to contact us with any questions you have about the panel.  

For further information about how we will protect your personal information and your rights, find out more in our privacy policy here: https://www.actiononhearingloss.org.uk/help/privacy/

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* 1. Please tell us your name:

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* 2. Please provide an email address that we can use to contact you about research opportunities:

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* 3. Are you male or female?

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* 4. How old are you?

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* 5. Which of the following statements apply to you? (Please tick all that apply)

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* 6. Where do you live?

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* 7. Are you currently a member of Action on Hearing Loss?

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* 8. To which of these ethnic groups do you consider you belong?

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* 9. How did you find out about the Action on Hearing Loss research panel?

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