Ambulance Victoria General Portal

Ambulance Victoria - General Questionnaire

Informed Consent

The quality of this project depends on your willing participation so you are assured of confidentiality with your data stored on STAGE-28’s encrypted servers. STAGE-28 is an organisation committed to high-quality research to benefit emergency service personnel so its security measures will deny access to any colleague, manager or organisation you may be associated with. Your e-mail address will be retained at STAGE-28 to send information regarding your mental health as revealed by your scores.

There are two portals:

1. A ‘general’ mental health and wellbeing portal completed at the start and end of the project, and

2. An ‘incident’ portal completed after certain critical incidents and again 1-3 days later.
If you wish to withdraw at any time let us know and your data will be traced and deleted. Contact details, research information and how to raise concerns appear on the final page, where you submit this form. Your consent is assumed for the six months this project is expected to run. An information sheet we recommend you read can be downloaded here: Information Sheet.

Please tick this box to say you give your consent. *
Two initials plus 4-digit birthday and month For example: for Joe Smith born 24/08/77 enter: ‘JS2408’
Age: *
Gender Identity: *
Current status: *
YY/MM
Sending

©2021 Dr John Durkin

Privacy Policy Cookie Policy

Site Designed by GWD Services

STAGE-28