Your school board and Wellington-Dufferin-Guelph Public Health are inviting you to participate in a survey. We want to learn about the well-being and health of students like you. What is the purpose of the survey?
The survey asks about your health and well-being so that we can understand your needs. Your answers to this survey and the answers of your classmates will help us plan programs to make your school and our community a better place to live.
What we are asking you to do:
We want you to answer the questions on this 30-minute survey. There are no right or wrong answers. Do not spend too much time on any one question. Go with the answer that first comes to your mind. Please read each question carefully and answer honestly. If you don't know the answer to a question, leave it blank. You can also skip any question if it makes you uncomfortable.
If you need help filling out this survey, please talk to your teacher.
Do you have to do this survey?
You do not have to do this survey. It is up to you. You can say no now or you can even change your mind later. No one will be upset with you if you decide not to do this survey.
Your grades and your relationships with your school, teachers and public health will not be affected if you choose not to do the survey or if you choose to stop at any point. If you do choose to stop, you can choose to delete your answers or keep your answers. If you keep your answers, we can still use those answers to help us understand student health. Once you've finished the survey or if you close your internet browser suddenly, you can't delete any answers and they will be saved.
Could this survey hurt or help you in any way?
Some questions in this survey might make you feel uncomfortable and you don't have to answer those if you don't want to. If you feel uncomfortable after doing this survey, you can talk to your guidance counselor or call the Kids Help Phone (1-800-668-6868). This survey could help you because we will use the answers to improve your community and school.
What will we do with information about you?
When you finish the survey, your answers will go to Public Health. Your answers will not be seen by anyone at your school, including your teachers and parents. Public Health will be very careful to keep your answers to the survey private. Public Health will keep all information we collect about you locked up and password protected. They will take all information from all students who do this survey to create reports for schools, the community, and other professionals. Your name or any other information that could tell us who you are will not be used in any reports. The reports will be available on the Report Card Coalition Website: www.wdgreportcard.com. Data collected from the survey will be kept on a secure network for at least six years.
This survey has received an approval from an ethics review. If you have questions about this, contact Jennifer MacLeod at 1-800-265-7293 ext. 4370 or by email at jennifer.macleod@wdgpublichealth.ca
If you have any other questions, you can contact:
Blair Hodgson
Wellington-Dufferin-Guelph Public Health
Phone Number: 1-800-265-7293 ex. 4312
Email Address: blair.hodgson@wdgpublichealth.ca
The information on this form is collected under the authority of the Health Protection and Promotion Act in accordance with the Municipal Freedom of Information and Protection of Privacy Act and the Personal Health Information Protection Act. This information will be used for the delivery of public health programs and services; the administration of the agency; and the maintenance of healthcare databases, registries and related research, in compliance with legal and regulatory requirements. Any questions about the collection of this information should be addressed to the Chief Privacy Officer at 1-800-265-7293.