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Study ID: HUM00137504 IRB: IRBMED Date Approved: 10/14/2020 Expiration Date: 10/13/2021 UNIVERSITY OF MICHIGAN CONSENT TO BE PART OF A RESEARCH STUDY NAME OF STUDY AND RESEARCHERS Title of Project: Pregnancy Outcomes and Experiences among Deaf and Hard of Hearing Women Principal Investigators: Michael McKee, MD, MPH, Department of Family Medicine, University of Michigan Monika Mitra, Ph.D., Brandeis University, Lurie Institute for Disability Policy GENERAL INFORMATION This survey is being conducted by Brandeis University and the University of Michigan Medical School and is sponsored by the National Institutes of Health (NIH) (Award number R01HD090103) The goal of this research study is to understand the needs of Deaf and hard of hearing women around the time of pregnancy We are asking Deaf and hard of hearing mothers who have given birth to a child within the last 10 years to complete this confidential online survey The survey asks questions about the care you received during your last pregnancy and will take about ~40 minutes Participation is voluntary You can skip any question you not want to answer and you can stop at any time Refusing to participate will not affect the care or benefits you might receive at your healthcare clinic Answering our survey won’t benefit you directly We hope what we learn will help other people in the future Your survey answers will be combined with responses from other survey participants After you finish the survey, we will ask if you want to provide your name and contact information to be entered into a drawing to receive a $50 gift card to Amazon We will also ask if you want to be contacted about future research projects If you choose to provide contact information, it will be stored separately from your survey answers Any information you provide will be limited to people who have a need to review this information for purposes of this study, or related future studies CONTACT INFORMATION To request accommodations or if you have any questions, concerns, or complaints about this survey, you can email the research team at melwein@med.umich.edu or by VP at 734-418-0510 You may also express a concern about a study by contacting the Institutional Review Board: Study ID: HUM00137504 IRB: IRBMED Date Approved: 10/14/2020 Expiration Date: 10/13/2021 University of Michigan Medical School Institutional Review Board (IRBMED) 2800 Plymouth Road Building 520, Room 3214 Ann Arbor, MI 48109-2800 734-763-4768 E-mail: irbmed@umich.edu If you are concerned about a possible violation of your privacy or concerned about a study, you may contact the University of Michigan Health System Compliance Help Line at 1-866-990-0111

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