Jeffrey Breugelmans, PhD
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Northeastern University. Mechanical and Industrial Engineering Department

Name of Investigators: Prof. Yingzi Lin and Ph.D. Candidate Jeffrey Breugelmans

Title of Project: Providing Computer Accessibility to the Physically Disabled

Request to Participate in Research. We would like to invite you to participate in this survey. The survey is part of a research study which purpose is to identify and resolve the issues faced by physically disabled computer users. This survey should take 10-15 minutes to complete. We are asking you to participate in this study because we value your insights as a potentially valuable source of information. Please note that you must be at least 18 years old to participate.

The decision to participate in this research project is voluntary. You do not have to participate and you can refuse to answer any question. Should you feel uncomfortable answering any of the survey questions, please feel free to skip ahead.

There are no direct benefits to you from participating in this study. However, your responses may help us learn more about potential usability issues, and what can be done to address these.

You will not be paid for your participation in this study. However, you may qualify to participate in a system testing trial that does involve compensation. These trials will take place at our research facilities at a later time this year.

Your part in this study is anonymous to the researchers. By using the provided return envelope you can submit your survey without revealing your identity. Any reports or publications based on this research will use only group data and will not identify you or any individual as being affiliated with this project.

If you have any questions regarding privacy, please feel free to contact Mark Nardone, NU’s Director of Information Security via phone at 617-373-7901, or via email at privacy@neu.edu.

If you have any questions about this study, please contact Jeffrey Breugelmans (Email: j.breugelmans@neu.edu; Tel: 617-971-7861), the person mainly responsible for the research. You can also contact Yingzi Lin (Email: yilin@coe.neu.edu), the Principal Investigator.

If you have any questions regarding your rights as a research participant, please contact Nan C. Regina, Director, Human Subject Research Protection, 960 Renaissance Park, Northeastern University, Boston, MA 02115. Tel: 617-373-4588, Email: irb@neu.edu. You may call anonymously if you wish.

By completing the survey you are indicating that you consent to participate in this study. When sending us your answers please save or print a copy of this consent form for your records.

Thank you for your time.

Jeffrey Breugelmans
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