You are being asked to join a research study. This form gives you important information that will help you decide whether or not to take part. It describes what would happen to you in the study, and helps you understand the reasons why you might or might not want to participate. To participate, you must be 18 years old and be fluent in English. The purpose of this research study is to examine the relationship between previous adverse experiences and physical and mental health. If you agree to participate in this research study, we will ask you to do the following: Provide answer to multiple choice questions about: some demographic information, your past experiences, your current experiences, behaviors, and emotions.

Your participation in this research will take about 30 minutes. There are minimal risks to your participation in this study. Some of the questions the researchers ask you may be upsetting, or you may feel uncomfortable answering them. If you do not wish to answer a question, if you do not wish to answer a question, you are free to discontinue your participation.

We will make our best efforts to maintain confidentiality of any information that is collected during this research study. We will protect your confidentiality by not collecting any identifying information from you. That is, your participation is completely anonymous. The researchers will not be able to trace you from the responses you provide. The data will be stored in a college owned computer to which only the researchers and faculty advisor will have access. Publications and/or presentations that result from this study will not identify you as your participation is anonymous. The information that we collect from you as part of this study will not be used or distributed for future research. You will not directly benefit from your participation in this research study. The knowledge gained from this study may help the researchers understand the relationship between distressing events and physical health, which can potentially lead to designing interventions for individuals in the future. There will be no cost to you if you participate in this research study. You will not receive any payment for participating in this research study. Your participation in this research study is entirely voluntary.  If you decide not to participate, there will be no penalty to you, and you will not lose any benefits to which you are otherwise entitled. You can decide to withdraw your consent and stop participating in the research without any penalty. You are not giving up any of your legal rights by agreeing to participate.

If you have any questions, comments or concerns about the research, you can contact the researcher Dr. Barahmand usha.barahmand@qc.cuny.edu. If you have questions about your rights as a research participant, or you have comments or concerns that you would like to discuss with someone other than the researchers, please call the CUNY Research Compliance Administrator at 646-664-8918 or email HRPP@cuny.edu.