Electronic Informed Consent Agreement

Study Title: Psychological effects of extraordinary experiences.
Protocol #: 7036

Please read this consent agreement carefully before you decide to participate in the study.

Consent Form Key Information:
• Participate in a 1-hour study about the psychological correlates of OBEs
• No information collected that will connect identity with responses

Purpose of the research study: The purpose of the study is to investigate the psychological outcomes of OBEs.

What you will do in the study: In this study, you will be asked to complete several questionnaires. These will cover topics such as your psychological well-being, fear of death, level of spirituality, life satisfaction, materialistic values, connection with others and nature, empathy, and gratitude.

Time required: The study will require about 1 hour of your time. The scales can be completed in multiple sessions, and at your own pace.

Risks: There are no foreseeable risks from participating in this study. However, please be aware that some of the questions you may encounter could evoke feelings of sadness, anger, regret, or other strong emotions. If you feel the need to talk to someone, please reach out to the principal investigator of this study at zzs2jq@uvahealth.org. They can readily direct you to appropriate resources and support.

Benefits: There are no direct benefits to you for participating in this research study. The study may help us understand if the presence of regular out-of-body experiences is related to neuropsychiatric conditions.

Confidentiality: The information that you give in the study will be anonymous. Your name and other information that could be used to identify you will not be collected or linked to the data. Because of the nature of the data, it may be possible to deduce your identity; however, there will be no attempt to do so and your data will be reported in a way that will not identify you.

Voluntary participation: Your participation in the study is completely voluntary. You may end a survey at any time and skip any questions that you do not wish to answer.

Right to withdraw from the study: You have the right to withdraw from the study at any time without penalty.

Payment: You will not receive payment for completing the surveys for this study.

Please contact the researchers on the study team listed below to:
• Obtain more information or ask a question about the study.
• Report an illness, injury, or other problem.
• Leave the study before it is finished.

Marina Weiler, Ph.D.
Division of Perceptual Studies
Department of Psychiatry and Neurobehavioral Sciences
PO Box 800623
Charlottesville, VA 22903
Telephone: (434) 924-2281
Email address: zzs2jq@uvahealth.org

You may also report a concern about a study or ask questions about your rights as a research subject by contacting the Institutional Review Board listed below.

Tonya R. Moon, Ph.D.
Chair, Institutional Review Board for the Social and Behavioral Sciences
One Morton Dr Suite 400 University of Virginia, P.O. Box 800392
Charlottesville, VA 22908-0392
Telephone: (434) 924-5999
Email: irbsbshelp@virginia.edu
Website: https://research.virginia.edu/irb-sbs
Website for Research Participants: https://research.virginia.edu/research-participants

UVA IRB-SBS # 7036