V anderbilt u niversity Center for Community Studies



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Courte C. W. Voorhees at (615) 428-4421 or my Faculty Advisor, Dr. Douglas D. Perkins at (615) 322-3386., or the Vanderbilt University Institutional Review Board Office at (615) 322-2918 or toll free at (866) 224-8273.
STATEMENT BY PERSON AGREEING TO PARTICIPATE IN THIS STUDY

I have read this letter or it has been read to me. The information in it has been explained to me verbally. All my questions have been answered, and I freely and voluntarily choose to participate.

Date Signature of volunteer

Consent obtained by:


Date Signature



Printed Name and Title









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