The Department of Family and Community Medicine at Baylor College of Medicine is conducting a research study to collect information on barriers and facilitators to engaging in buprenorphine-assisted treatment for opioid use disorder. This study requires the study participants to be at least 18 years old and involves answering questions on a short survey that will take no more than 10 minutes to complete.

Completing the questionnaire is for research purposes only. If you consent, please complete this anonymous questionnaire. Please do not print or sign your name on the questionnaire. We will take all necessary steps to keep any information shared with us confidential. Data from your survey will not be shared with any other person or entity, except as required by law, for authorized oversight of the research study.

• If you complete this survey, it is assumed that you volunteered to participate in the research study.
• You must be at least 18 years old or older to participate.
• Declining to participate will not affect your employment or residency evaluation in any way.
• You can decide to stop answering the questions in this survey at any time. The data you provide up to this point may still be used for research.
• You may choose to skip any questions that make you feel uncomfortable, or that you do not want to answer. After you submit the survey, you will be provided a code to review your answers and complete any questions you did not complete.
• The potential risks of participating in this survey include emotional discomfort and loss of confidentiality.

Thank you for your participation in this research study. If you have any questions about the study, please contact Hillary Kim-Vences (sungin.kim-vences@bcm.edu). If you have questions about your rights as a research study participant, please contact the Institutional Review Board at Baylor College of Medicine at (713) 798-1000.

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