THE EFFECTS OF A PROBIOTIC SUPPLEMENT ON
SYMPTOMS OF ADHD AND ANXIETY IN CHILDREN


Patrick Bazinet, Graduate Student Researcher, email:probiotickids@gmail.com
Amanada Williams, Graduate Student Researcher, email: probiotickids@gmail.com
Dawn Armstrong, Honours Student Researcher, email: probiotickids@gmail.com
Dr. Mark Johnston, Primary Investigator, email: mark.johnston@truenorthcr.com, tel: (902) 679-0536
Dr. Susan Potter, Primary Investigator, email: susan.potter@acadiau.ca, tel: (902) 585-1220
Department of Psychology, Acadia University

Attention: The lab will be closed over the Holidays. We will look forward to contacting you in the new year to set up an appointment time.

Online Consent Form for Preliminary Questionnaire

You and your child have been invited to participate in a study examining the effects of probiotics on the symptoms of attention deficit-hyperactivity disorder (ADHD), anxiety, and associated physiological and psychological factors, as described in the project information sheet. Please review the information sheet before consenting to participate. This consent form is for the initial online questionnaire only, described in section 4 on the information sheet. This questionnaire will help the researchers determine if your child is a good candidate for the study and provide them with useful information if your child meets the eligibility criteria and you and your child decide to participate.
 
By checking the box below you are indicating that you are the legal parent or guardian of your child and that you have signing authority for your child, that you have read the information sheet, that you understand the nature of the study and what is required of you and your child, and you are providing your free and informed consent to participate in the initial screening questionnaire for this study. Although we do not anticipate any problems associated with taking the probiotics or placebo, by consenting to participate, you are not waiving your right to legal recourse in the event of any research-related harm. Your participation in this research project is greatly appreciated.
 
Contact information collected during this study will be used only for the purpose of this study. 
I have read and understand the above information and hereby consent to participate in the initial screening portion of this study. I am free to discontinue my participation at any time. 
Note: if you encounter any difficulties while completing this questionnaire, please click the back button on your browser and try clicking next again. If you continue to encounter difficulties please email the researcher.