CONSENT FORM

INVITATION TO PARTICIPATE: Any one in or involved in an intimate relationship can participate in this research study.

PURPOSE: The purpose of this research study is to test WWW-based data collection of information about how couples interact. We are interested in understanding satisfaction in your romantic relationship, and how this is related to your communication in this relationship.

PROCEDURES: If you click "I CONSENT" you will be asked to answer a series of questions about your mood, your satisfaction in your intimate relationship, your communication, and demographic questions such as your age, race, length of relationship with your romantic partner, etc. We will not ask your name or other identifying information, but if you wish to have the results of the study emailed to you, you will need to supply your email address. So that we may link your responses to your romantic partner's without identities, you will be asked to provide his or her initials, month and day of birth, as well as providing this same information for yourself. Completing the questions takes about 10 - 20 minutes.

RISKS: Some of the questions to be too personal or may make you feel somewhat uncomfortable. If so, you can leave those questions blank.

BENEFITS: This survey is not designed to benefit you directly, but we hope that it will help other couples by advancing knowledge about couples' relationships.

COMPENSATION: If you provide an email address, you will be entered into a drawing for $300 for completing this survey. If you win, you will be contacted for payment information. The drawing will be conducted after 100 participants have completed the survey.

CONFIDENTIALITY: Every attempt will be made to keep your information strictly confidential, except as may be required by court order or by law. Authorized representatives of the University of Pennsylvania Institutional Review Board (IRB), a committee charged with protecting the rights and welfare of research subjects, may be provided access to these research records. No study results will be presented with email addresses or any other identifying information.

SUBJECT RIGHTS: If you have questions about your rights and this study, call the Director of Regulatory Affairs at the University of Pennsylvania by telephoning (215) 898-2614.

Contact Dr. Sayers at (215) 823-5196 with any questions or concerns about your participation in this study.