Project RISE Feedback Form
===== Study Title =====
Smoke Labeling Tool Evaluation Survey Research

===== Principal Investigator =====
Illah R. Nourbakhsh, Professor,, The Robotics Institute, Carnegie Mellon University, Pittsburgh, PA 15213, USA

===== Other Investigator(s) =====
Yen-Chia Hsu and Jessica Pachuta, {yenchiah, jpachuta}, The Robotics Institute, Carnegie Mellon University, Pittsburgh, PA 15213, USA

===== Purpose of this Study =====
The purpose of the study is to evaluate Project RISE ( This research will measure community engagement by understanding: (1) the motivations of using the tool, and (2) the levels of participation. The result will greatly benefit the research of how to develop a system for community engagement.

===== Procedures =====
If you decide to take part in this study, you will fill out a survey. We do not record video or audio during the study. The survey is expected to take less than 5 minutes.

===== Participant Requirements =====
Participation in this study is limited to individuals age 18 and older.

===== Risks =====
The risks and discomfort associated with participation in this study are no greater than those ordinarily encountered in daily life or during other online activities. The primary risk is breach of confidentiality.

===== Benefits =====
There may be no personal benefit from your participation in the study, but the knowledge received may be of value to humanity.

===== Compensation & Costs =====
There is no compensation for participation in this study. There will be no cost to you if you participate in this study.

===== Future Use of Information and/or Bio-Specimens =====
The collected data will be used to inform the design of the smoke labeling tool. The de-identified data may be reported in research publications.

In the future, once we have removed all identifiable information from your data (information or bio-specimens), we may use the data for our future research studies, or we may distribute the data to other investigators for their research studies. We would do this without getting additional informed consent from you (or your legally authorized representative). Sharing of data with other researchers will only be done in such a manner that you will not be identified.

===== Confidentiality =====
All responses are kept confidential. This survey is anonymous, and we do not collect personally identifiable information. Your research data will be stored in a secure location on Carnegie Mellon property. By participating, you understand and agree that the data and information gathered during this study may be used by Carnegie Mellon and published and/or disclosed by Carnegie Mellon to others outside of Carnegie Mellon. Note that per regulation all research data must be kept for a minimum of 3 years. Annotation services for the data will not be used.

===== Rights =====
Your participation is voluntary. You are free to stop your participation at any point. Refusal to participate or withdrawal of your consent or discontinued participation in the study will not result in any penalty or loss of benefits or rights to which you might otherwise be entitled. The Principal Investigator may at his/her discretion remove you from the study for any of a number of reasons. In such an event, you will not suffer any penalty or loss of benefits or rights which you might otherwise be entitled.

===== Right to Ask Questions & Contact Information =====
If you have any questions about this study, you should feel free to ask them now. If you have questions later, desire additional information, or wish to withdraw your participation please contact the Principal Investigator by mail, phone or e-mail in accordance with the contact information listed on the first page of this consent.

If you have questions pertaining to your rights as a research participant; or to report concerns to this study, you should contact the Office of Research Integrity and Compliance at Carnegie Mellon University. Email: Phone: 412-268-1901 or 412-268-5460.

===== Important Notes =====
Please avoid revealing any private or personally identifiable information about yourself or anyone else in your responses to open- ended questions. Please answer each question carefully and to the best of your ability. Thank you!
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