• Price: $50
  • Area: Nationwide
  • Posted: 26 July 13
  • Expire: Recurring
  • Age & Sex: M/F 18+


Title of project: Self-perceptions and the Future Self: Implications for Health and Well-being

Please read the following information about the study to be conducted.

I agree to participate voluntarily in a project being conducted by Fuschia M. Sirois, Ph.D. of the Department of Psychology at Bishop’s University, Lennoxville, Quebec and funded by the Canada Research Chairs program.


The purpose of the study is to explore how and why certain self-perceptions may be linked to the amount of consideration you give to your future self, and how this consideration of your future self may be linked to outcomes related to health and well-being.


As a participant in this project, I will be asked to complete an online survey which includes questions about how I view my future self, my self-perceptions, wellness behaviours, and my health and well-being.

This survey takes approximately 15 to 20 minutes to complete, although individual completion times may vary depending on your computer system. You may complete the survey at a location of your choice.


I am aware that at all times, I have the right to withdraw from the project without negative consequences. However, my responses will be anonymous and therefore I can only withdraw from this study up to the point that I click the “Submit Survey” button at the end of the survey.


Several steps will be taken to ensure the confidentiality of survey data you submit. All incoming surveys will be stored on a secure server and be accessible only by the researcher. The date and time of submission will be the only additional information attached to the surveys. Such information is used solely for the purpose of excluding duplicate submissions. Should you choose to enter the draw, the email address you provide will be used solely for the purpose of the draw and will be deleted after the draw is complete. However, your email address will not be linked to your survey responses.

All electronic data will be stored on a password protected computer in the researcher’s lab to further ensure privacy. Only the researcher and the research assistants directly associated with this study will have access to this information for the purposes of analysis and conducting the study. Any reports of this study made available to participants or sent to a scientific journal for publication will contain information that reflects group results and not information about specific individuals. Following the guidelines of the Canadian and American Psychological Associations, data will be retained for a period of 5 years after publication in a secure place, after which time it will be disposed of in a secure manner (e.g. shredded or electronically deleted).

All data collected will be confidential and the property of the researcher, and will be used strictly for the above-mentioned project. However, this data may also be used by the researchers for subsequent studies upon receiving further clearance from the Research Ethics Board.


There are no risks anticipated from participating in this study.


The potential benefits resulting in my participation are that I may become more aware of my thoughts and feelings towards my future self.
The results from this study may advance knowledge regarding how attitudes towards the future self are linked to health and well-being.

Contact Information

Dr. Sirois can be reached at (819) 822-9600, ext.2790 or by email at This email address is being protected from spambots. You need JavaScript enabled to view it.. The University’s Research Ethics Board approved this project on June 8, 2012. If I have any concerns regarding this project, I may contact Dr. Christopher Stonebanks, Chair of the Research Ethics Board of Bishop’s University (819-822-9600, ext. 2203) or Dr. Steve Harvey, Associate Vice-Principal of Research of Bishop’s University (819-822-9600, ext. 2622).

I agree to participate in this project and I have made this decision based on the information I have received about it. I have read and understand the present consent form and I accept its stipulations.

I understand that by completing and submitting this electronic survey that I am giving my consent to participate in this study according to the terms outlined above.

It is recommended that you print out a copy of this letter of information for your records.

Pass it on: Feel free to send the link for this page to other people who you know who might be interested in participating.

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