Welcome!

Before you continue, we would like to clarify a few things about this survey. Please read this carefully and contact us with any questions before clicking the "I consent" button.

• Purpose: The data collected from this survey will be used in a 6-month study to determine the level of hepatitis B and liver cancer knowledge at college campuses and the effectiveness of current outreach techniques employed by Team HBV chapters.
• Who: Anyone in the Cornell and Duke communities over the age of 18 is invited to participate. This study is being conducted by B-Aware at Cornell University (teamhbv.org), Team HBV at Duke University (teamhbv.org), and the Asian Liver Center at Stanford University (http://liver.stanford.edu).
• What: You will be asked to fill out a 20 question survey on how much you know about hepatitis B and liver cancer that will take approximately 10 minutes.
• Risks: No personally identifiable information will be attached to your survey responses and every possible measure to protect your privacy has been undertaken.
• Benefits: If you are a member of the Cornell community and you agree to submit to your email address, you will be entered in a raffle for free prizes (see our website). Filling out this survey will help us better design our outreach efforts and teach you about hepatitis B and liver cancer.
• Voluntary and Confidential: This survey is completely voluntary and you may stop taking it at any time. All information will be kept confidential and only made available to the primary investigators. Each participant will be assigned a random numeric code to protect your identity. Though we will do everything possible to maintain your privacy, the Internet is neither completely private nor secure, and your answers may be viewed by unauthorized third parties.
• For more information: If you have any questions and would like to discuss any aspect of this study with the principal investigators before continuing, please contact Amanda Wong (Cornell) at ajw54@cornell.edu or Jian Zheng (Duke) at jian.zheng@duke.edu.

Please print this form now if you would like a copy for your records.

• Statement of Consent: I have read the above information and have received answers to all my questions. I am at least 18 years old and I consent to take part in this study.
• This consent form will be kept by the researchers for at least three years beyond the end of the study and was approved by the UCHS (Cornell's IRB) on October 17, 2006.