Consent Form for Participation in Dry Eye Research Project


Study Title: Understanding Dry Eye Disease Through Symptom Logging


Purpose of the Study

Thank you for your interest in participating in this research project. This study aims to improve the understanding of dry eye disease by collecting and analyzing user-reported data via an innovative, patient centric approach. Your contributions will help us develop a new approach of treatments and management strategies for dry eye.

What Participation Involves

By participating, you agree to:

1. Log your dry eye symptoms and related details (e.g., lifestyle habits, treatments, or environmental factors) through our website.
2. Share any additional information you are comfortable providing, such as general health details or medication use.

Participation is voluntary, and you may withdraw at any time without penalty.

Your Data

  1. How Your Data Will Be Used:
    Your data will be anonymized and analyzed for research purposes. Results may be published in scientific journals or presented at conferences, but no information that identifies you will ever be shared.

  2. Data Protection:
    Your information will be stored securely in compliance with usual data protection laws, e.g., HIPAA, GDPR, PIPEDA, APPs. Only authorized personnel will have access to the data.

  3. Data Sharing:
    Data will not be shared with any external parties, unless required by law.

  4. Duration:
    Your data will be retained for a period of five (5) years to support ongoing research, after which it will be securely deleted.

Your Rights

You have the right to:
Withdraw from the study at any time.
Request access to your data or ask for it to be deleted.
Decline to answer any specific questions or share specific details.
To exercise these rights, please contact us at: data@dryeye-research.org.

Contact Information

If you have any questions or concerns about this study, please contact contact@dryeye-research.org.

Consent

By clicking the button below, you confirm that:
- You have read and understood the information provided above.
- You agree to participate in this research study.
- You understand that your participation is voluntary and that you can withdraw at any time.

By clicking the button below, I consent to participate in the research project and share my data as described above.