Dear Participant:

You are being invited to participate in a research study about possible effects of tear gas in the U.S. by answering questions in the attached survey. The purpose of this study is to learn more about how tear gas affects different aspects of health, both in the short term and after several months. This study is conducted by Dr. Kira Taylor, Dr. Ted Smith, Dr. Aruni Bhatnagar, and Dr. Cynthia Corbitt of the University of Louisville, in collaboration with Dr. Monica Unseld of the Until Justice Data Partners. There are no known risks for your participation in this research study. The information collected may not benefit you directly. The information learned in this study may be helpful to others. The information you provide will provide a basis for future research and the results could affect policies about tear gas use. Your completed survey will be stored at the University of Louisville on a secure, password-protected computer. The survey will take approximately 30-45 minutes time to complete. You will be invited by email to complete follow-up surveys on a monthly basis, to update any new information about tear gas exposure and health.

Individuals from the Department of Epidemiology and Population Health, the Institutional Review Board (IRB), the Human Subjects Protection Program Office (HSPPO), and other regulatory agencies may inspect these records. In all other respects, however, the data will be held in confidence to the extent permitted by law. Should the data be published, your identity will not be disclosed.

Taking part in this study is voluntary. By answering survey questions you agree to take part in this research study. You do not have to answer any questions that make you uncomfortable. You may choose not to take part at all. If you decide to be in this study you may stop taking part at any time. If you decide not to be in this study or if you stop taking part at any time, you will not lose any benefits for which you may qualify.

If you have any questions about your rights as a research subject, you may call the Human Subjects Protection Program Office at (502) 852-5188. You can discuss any questions about your rights as a research subject, in private, with a member of the Institutional Review Board (IRB). The IRB is an independent committee made up of people from the University community, staff of the institutions, as well as people from the community not connected with these institutions. The IRB has reviewed this research study.

If you have any questions, concerns, or complaints about the research study, please contact:

Kira Taylor, Ph.D.

University of Louisville, Department of Epidemiology and Population Health

School of Public Health and Information Sciences

485 E Gray St.

Louisville, KY 40202

502-852-4063

If you have concerns or complaints about the research or research staff and you do not wish to give your name, you may call 1-877-852-1167. This is a 24 hour hot line answered by people who do not work at the University of Louisville.

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