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CONSENT FORM

 

Title of Project:

Name of Researcher:

Participant Identification Number:

 

Your Informed Consent

          

I confirm that I have read the participant information sheet for the above study. YES/NO

 

I have had the opportunity to consider the information, ask questions and have had these answered satisfactorily. YES/NO

 

 

I understand that my participation is voluntary and that I am free to withdraw at any time without giving any reason, without my legal rights being affected. YES/NO

 

I agree to take part in the above study. YES/NO                                                                                        

 

 

Any personal or business information that you provide during this research session will be held in the strictest of confidence and your details will not be passed on to a third party unless this is clearly specified to you.

 

Participation in this research is entirely voluntary. You can refuse to answer any questions or even withdraw at any stage by confirming this to the researcher.

 

Your data

To help us analyse and share our findings, we take notes as standard in all sessions and may take pictures or record audio to make this note taking process easier. The audio recording is for note collection only and will not be shared, if at any point you do not want to be recorded please let the researcher know. Anything you say and do will be anonymized in our reports, but your data will be stored with your name so we can find it if you choose to withdraw it.

 

All data will be treated as personal under the 2018 Data Protection Act, and will be stored securely. Where possible we will use a participant identification number and keep this separately to your name.

 

I consent to audio recording of the session for research and analysis.

 Yes   /   No

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I consent to photographs of my working environment being taken

 Yes   /   No

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I’m happy that anonymised quotes are used to improve products or services that may be shown to people outside of Humanise

Yes   /   No

 

Your agreement

 

I agree to take part in the research session based on the information provided and the handling of my data as noted above.

 

 

 

 

                                                                                                                                   

Name of Participant

 

Date

 

Signature

 

                                                                                                                                   

Name of Person taking consent

 

Date

 

Signature