Acha Institution Of Higher Education Demographic Survey Form (Page 5 of 5) in pdf

Acha Institution Of Higher Education Demographic Survey Form Page 5

Section 3. Data Agreement and Contact Information

Thank you for completing the above information and for helping us better use the ACHA-NCHA survey data in

developing normative information for a variety of variables.

The ACHA-NCHA is being used across the nation to assess student health risks, beliefs, behaviors, and

consequences. Each participating institution of higher education (IHE) receives a copy of its data file and

reports for the purposes of analysis, research, and program planning. Additionally, each participating

institution receives an aggregate report with data from all IHEs using random sampling methodologies that

participated in the same survey period. The creation of this large national data file and aggregate report allows

you to compare your students to a national sample. It also provides the opportunity for a greater understanding

of student health, what works to reduce student health risks and consequences, and what changes can be

brought about over time. In light of this opportunity, we are asking your permission to analyze, report on, and

use the data collected from your students to further both our understanding of student health needs identified

by the ACHA-NCHA and the ability of IHEs to meet these needs.

By signing below, I hereby agree to the following statement:

“I, as the ACHA-NCHA program representative at my institution, give the American College Health

Association permission to analyze, report on, and otherwise use the aggregate data. I understand that all

information in the aggregate data is protected and that the identity of my institution and the students who

complete the ACHA-NCHA will remain confidential at all times.”

Signature

Date

Name

Title

Institution

Phone

E-mail

Address

When all sections are complete, please either mail or fax this survey to:

1362 Mellon Road, Suite 180

Hanover, MD 21076

410.859.1510 (fax)

Direct all inquiries regarding completion of this survey to:

Mary T. Hoban, Ph.D., MCHES

Director, ACHA-NCHA Program Office

443-270-4558 (phone)

Page 5 of 5

Acha Institution Of Higher Education Demographic Survey Form Page 5