Consent Form

You are invited to participate in a study involving the planning and documentation of research, development and production activities of NIDILRR Technology Grantees.

In this study, you will be asked to describe your technology projects’ progress towards technology transfer or commercialization. You will be asked to share your project’s technology transfer or commercialization plan and participate in quarterly project surveys and interviews throughout the entire project. We will make an audio recording of all phone interview discussions to be used for reference by people involved in the case study. You will be asked to review your case summary for accuracy. In return for your collaboration, you will be offered guidance and technical assistance throughout your project for all your technology transfer or commercialization needs. If you choose not to participate in this case study, and you are receiving other services from KT4TT, the other services will not be affected in any way. However, our team will be more equipped to assist you if we are working more closely and on a continual basis as would be the case if you decide to participate in this prospective case study.


What is the purpose?

The purpose of this study is twofold, one to assist Technology Grantees with the planning and implementation of technology transfer or commercialization of their intended project outputs and two to enhance the NtK model with identified best practices of NIDRR Technology Grantees, making the model more relevant to federal grantees intending to improve the lives of people with disabilities through the commercialization of assistive technologies.

Why have I been asked?

You have been asked to collaborate in this project because you are a principal investigator or project manager of a newly funded NIDRR Technology Grant (RERC, DRRP, SBIR Phase 2, or FI).

What does my involvement consist of?

We will send you a questionnaire each quarter during the duration of your technology development project consisting of questions pertaining to the stage of development your project is in. We will follow up each questionnaire with a phone call interview to clarify any questions or responses on either end. You do not have to respond to any of the questions being asked of you. We may contact you briefly once a month to follow up on any activities that were unfinished during any particular interview session. We will send you a case summary of your project upon completion so that you can verify its contents.


Is there any risk?

No risk of harm or discomfort is anticipated, as you will respond to questions over the phone and on your computer. Questions relate to your project’s progress, specifically what actions you took to further the progress and the resulting consequences of those actions. There is no risk to your employment if you choose not to participate.

Participants will have the benefit of more efficient and timely technical assistance from the KT4TT because all team members will be involved in understanding your project and its progress from beginning to end. This will allow us to react more quickly to problems that you may encounter and also alert you to potential barriers before they arise. The likelihood of obtaining technology transfer success with your project’s output will be increased.  Your contributions to the case study will provide us the evidence base necessary to optimize the NtK model and will ultimately improve the chances of any researcher looking to transfer their discovery, invention, or innovation out to the marketplace.


Will compensation be made for any injury resulting from this study?

The State University of New York at Buffalo does not make any provision for medical care, nor is there any protection from the State for payment of compensation for medical care in the event of injury as a result of participation in the research project.

What if I change my mind?

Your participation is voluntary. You can quit at any time. You have the right to refuse to answer any particular questions. You also have the right to withdraw your own information at the end of the study or later and your information will be discarded and not used. If you decide now that you do not want to be audiotaped, you will not be eligible to participate in the study. This decision to withdraw will not affect any other services you are receiving in any way.

What are the benefits of the study?

You will be helping to validate and contextualize a useful step by step guide to creating and commercializing products that are truly needed and wanted by consumers that ultimately increase socioeconomic benefits. This guide will be utilized by federal technology grantees who have the research skills but may need assistance with the business and manufacturing elements of bringing a product to market.


What will happen with the results of the study?

All responses will be kept confidential. The responses will be maintained in a project file at the Western New York Independent Living Center, Inc. (WNYIL). Your name and any information which might identify you will be kept confidential. If any information we collect is printed in a report, it will be grouped together with information from other participants so that there is no way you could be identified. Your name will not appear in the report and all data will be reported as aggregate. The audiotapes will be used to be certain we accurately captured the comments made by all participants.

In order to monitor this research study, representatives from the DOE (Department of Education) and OHRP (Office of Human Research Protection) or representatives from the UB Human Research Protections Program may inspect the research records. This process may reveal your identity.

If you withdraw from this study, no further data will be collected, but any information that you have provided may be retained by the researcher and analyzed.


What should I do if I have questions?

Any questions, concerns or complaints that you may have about this study can be answered by Michelle Lockett, Senior Analyst.  Ms. Lockett can be reached through the Center for Assistive Technology, 100 Sylvan Parkway, Suite 400, Amherst, NY 14228 or by telephone, at (716) 204-8606.

What should you do if procedures are not followed?

If you have any questions about your rights as a participant in a research project, or questions, concerns or complaints about the research and wish to speak with someone who is not a member of the research team, you should contact (anonymously, if you wish) the Social and Behavioral Sciences Institutional Review Board, 515 Capen Hall, University at Buffalo, Buffalo, NY 14260, email, phone (716) 645-6474.


The State University of New York at Buffalo does not make any provision for medical care, nor is there any protection from the State for payment of compensation for medical care in the event of injury as a result of participation in a research project.

This document is to provide the information subjects need to know in order to make a good decision about study participation. It is not to execute a waiver of liability on behalf of the researcher, University, WNYIL, or sponsor.  By signing this form, you are not waiving any legal rights.

You may take as much time as you wish to think this over. Before you sign this form, please ask any questions on aspects of this study that is not clear.