Wellness Counseling Survey
As part of continued efforts to improve Wellness Counseling services at the American University of the Caribbean School of Medicine, we appreciate your feedback on services provided over the past semester (January-April 2007).  You have been provided this web link with information about participating in the survey because you provided your email address to me and consented to receiving email from me if necessary.  Your input is valuable in helping to improve student services provided to AUC students.  I hope you consider taking a few minutes to give your feedback electronically.

Participation in the Wellness Counseling Survey is voluntary and anonymous.   If you decide to participate, you will be requested to complete a survey asking you about demographic information; your experience in Wellness Counseling; and how you are doing now. The study is estimated to take approximately 7 minutes to complete.
If you are completing the survey on a computer accessible to others, there is a risk that they may see your answers. Therefore, I suggest that you do not take the survey at a public terminal or in a public space.
Confidentiality:
No specific identifying information will be collected. The IP address of the computer through which you access the survey may be monitored by Formsite.com (http://www.formsite.com). This information is used only to prevent multiple responses and is discarded after survey access is provided.  Neither I nor the university will have access to IP addresses of participants. 
The information sent through the online questionnaire is encrypted using technology similar to that used by online banking services.  Records will be stored electronically on CD for 7 years before destruction.  The data  will be reported in aggregate in a professional journal and professional presentation.
Participation and Withdrawal:
Participation in this survey is completely voluntary.  You are free to decide not to participate, or to withdraw at any time without adverse effect on your relationship with me or with the American University of the Caribbean.  You can end your survey participation by selecting another website in your web browser, or by closing your web browser. 
Identification of Investigator:
If you have questions or concerns about this survey, you can contact me in person, by phone or via email as listed below.  You can also contact  Ron Testa, Ph.D., Dean of Student Affairs at the American University of the Caribbean School of Medicine.  He can be reached by phone at (599) 545-2298, ext. 271, or by email at [email protected].

Thank you in advance for providing important feedback that will help improve services for all AUC students!

Cindy Ycaza Stroschein, Ph.D.
Wellness Counselor
Bullpen #3, Tien Wellness Center
American University of the Caribbean School of Medicine
#1 University Dr. at Jordan Rd.
Cupecoy, St. Maarten,
Netherland Antilles
Phone: (599) 545-2298 Extension 273
Email: [email protected].
I  would like to participate in the survey (clicking below  indicates informed consent to participate in the Wellness Counseling survey).
Hosted by www.Geocities.ws

1