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Elder Financial Exploitation Study Eligibility/Participation Form

If you meet these criteria, please fill out the following information so we may be in contact with you. Then complete the consent form, below this form on this webpage. Once we receive your signed consent form, we will email you a private, personal link to the survey or we can conduct the survey with you over the phone if you prefer. If you meet the criteria and your survey is completed, we will send you a $20 money order to compensate you for your time. One of our researchers or our research assistant will then contact you to schedule an interview to provide you an opportunity to share your story and to explain further your survey responses. We will again compensate you for your time.

If you are interested in participating in our survey, indicate (with a check) whether you meet each these eligibility criteria:

Yes

No

Yes

No

Yes

No

Yes

No

My family has had at least alleged or suspected an older relative is being exploited financially by a family member.

My family has had no problems with a relative financially exploitin an older relative.











Yes

No

Maybe



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Dr. Virginia Vincenti, Department of Family and Consumer Sciences

Laramie, WY

Phone: 307-766-4079

Email: vincenti@uwyo.edu

1000 E. University Ave. Laramie, WY 82071
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