Part 1. The Information Summary
Parental Rights:
• You have the right and the responsibility to be informed about what your child volunteers
to participate in at school.
• You have the right to receive accurate information about the Iowa Youth Survey
questionnaire so you can make decisions for your family.
Iowa Youth Survey Content:
In order to plan for the health, wellbeing and safety of all children living in Iowa, it’s important
that we understand their lives and experiences. While some sensitive questions about alcohol,
illegal drugs and violence may not apply to your student(s), these questions may be quite
relevant to others. When we know the range of experiences and values that exist in our student
population, we can better meet their needs. Your student(s) honest answers will help us reach
that goal. We value your support.
Confidentiality:
IDPH has measures in place to protect student confidentiality. All information collected will be
anonymous. Students will not put names, birthdates, or student numbers on the survey. In
publicly presented reports and reports delivered back to schools, no information about a question
will be reported for a grade level if fewer than 11 students in that grade level at that school
answer a question. IDPH may share the data collected through this survey to researchers or other
organizations for the purpose of special studies and analyses only after the receiving entity signs
an agreement with IDPH agreeing to maintain the confidentiality of all data received.
Compensation:
There will be no compensation or reward for students participating in the survey.
Voluntary:
• All students in 6th, 8th, and 11th grades will be invited to complete the Iowa Youth Survey.
Students will have the right to refuse to participate in the survey and to refuse to answer
any questions on the survey. If students decide they want to change their mind and quit
answering the survey at any time, they may do so.
• If, as a parent or legal guardian, you do not want your student(s) to participate, you must
send the school the Refusal of Consent form provided at the end of this letter (Part 3).
Your student(s) will be provided a neutral activity during the survey class period. There
is no penalty for anyone who decides not to participate.
Risk:
There is no direct risk involved in filling out the survey. Students may find some questions
uncomfortable to answer. They may skip any question they do not wish to answer or stop
completing the survey entirely at any point.
Benefits:
There will be no direct benefits to the students the day of the survey. The data collected
throughout the state will provide schools and communities with the information they need to
provide programs that will support schools, communities and families in keeping their children
safe and hopeful about their future. The data are vital for grant writing purposes and legislative
decisions.
Questions:
Questions regarding the Iowa Youth Survey are encouraged. Please contact your school
principal, superintendent, or the Iowa Department of Public Health at
iowayouthsurvey@idph.iowa.gov.
Part 2: Reviewing the Survey
A copy of the Iowa Youth Survey will be available to preview at the school office and may also
be viewed at: https://iowayouthsurvey.idph.state.ia.us/Announcements.
Part 3: Refusal of Consent
I have read the Information Summary provided. I understand that my student(s) participation in
the survey is strictly voluntary. I also understand my right to review the survey online, at the
school office and/or District Administration Office.