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INFORMATION & CONSENT SHEET
Invitation to take part
You are being invited to take part in a research study to further our understanding of [topic]. Thank you for carefully reading this information sheet, a copy of which you can keep for your records. This study is being conducted by student researcher [student name] and/or project supervisor [staff name incl. title] from the School of [School name], AVƵ, who is/are happy to be contacted ([email]) if you have any questions. The research is additionally being funded by [e.g., Wellcome Trust].
Why have I been invited to take part and what will i do?
We are testing OR surveying OR interviewing [number of] people who [explain] OR typical adults OR typical children, and the test OR questionnaire OR interview will take [study length]. You will [summary of task instructions]. We will be [explain what you are measuring and your methods of data collection; e.g., accuracy/audio/video].
are there any risks or benefits to taking part?
** If there are no risks or benefits please leave out this section. You have already noted above that the study is furthering scientific knowledge so do not repeat this here.
What will happen to the results and my personal information?
The results of this research may be written into a scientific report for a [degree name] dissertation and/or publication. We anticipate being able to provide a summary of our findings on request from [date] ([email]). Your anonymity will be ensured in the way described in the consent information below. Please read this information carefully and then, if you wish to take part, please sign to show you have fully understood this sheet, and that you consent to take part in the study as it is described here.
CONSENT
I understand that by signing below I am agreeing to take part in the AVƵ research described here, and that I have read and understood this information sheet.
I understand that my participation is entirely voluntary, that I can choose not to participate in part or all of the study, and that I can withdraw at any stage without having to give a reason and without being penalised in any way (e.g., if I am a student, my decision whether or not to take part will not affect my grades).
I understand I can request without penalty that my data be withdrawn and deleted even after the data collection is complete, any time up until the results are analysed ([date]).
OR
I understand that since the study is anonymous, it will be impossible to withdraw my data once I have completed and submitted the test/questionnaire.
I understand that my personal data will be used for the purposes of this research study and will be handled in accordance with HYPERLINK "http://www.sussex.ac.uk/ogs/policies/information/dpa/" Data Protection legislation. I understand that the Universitys HYPERLINK "/about/website/privacy-and-cookies/privacy" Privacy Notice provides further information on how the University uses personal data in its research..
I understand that my collected data will be stored in a de-identified way (e.g. using ID numbers not names), and kept separate from other details about me (e.g. from the consent form). Electronic data will be stored securely on a University managed system, and hard-copies will be stored behind a locked door. OPTIONAL: De-identified data may be made publically available through [data archive name] online data repositories or at the request of other researchers.
OR
I understand that my data including my personal information (i.e. any information that could identify me) will be stored safely. Electronic data will be stored securely on a University managed system, and hard-copies will be stored behind a locked door. OPTIONAL: De-identified data may be made publically available through [data archive name] online data repositories or at the request of other researchers.
I understand that my identity will remain confidential in any written reports of this research, and that no information I disclose will lead to the identification in those reports of any individual either by the researchers or by any other party, without first obtaining my written permission.
OR
I understand that I have given approval for my name and/or the name of my town/community, and/or the name of my workplace to be used in in any written reports of this research.
OR
I understand that I will be given a transcript of data (concerning my identify and performance) for me to approve before it is included in in any written reports of this research.
OR
I understand that [outline steps to be taken] will be done to prevent my identify from being made public.
I understand that my name and data will not be shared with any third party outside the research group, unless I later provide written permission.
AND/OR
I understand that confidentiality cannot be guaranteed for information which I might disclose in the focus group(s)/ group interviews.
AND/OR
Please initial this box if you consent for us to share with other researchers or interested professional parties images from the video of your participation.
Our research group at the AVƵ carries out studies on [topic]. Please initial this box if you are happy for us to include your data again in future studies if these have gained independent ethically approval, based on the strict confidentiality terms described above.
________________________ ________________ _____________________
Name of Participant Date Signature
Independent Witness*
I believe the above-named participant understands the information give and consents voluntarily.
________________________ ________________ _____________________
Name of Witness Date Signature
*Witness required only where there is some relationship between participant and researcher which might be deemed to unduly influence participants voluntary consent.
Study Name: [Study title, worded for lay-person]
Date: [date]
Version: [number]
Use for projects submitted to the SREO: For further information about this research please contact [student name] OR the project supervisor [name] ([email address]). This research has been approved ([reference number]) by the School of [School name]. If you have any ethical concerns, please contact the project supervisor [name] ([email address]). The AVƵ has insurance in place to cover its legal liabilities in respect of this study.
Use for projects submitted to the CREC: For further information about this research please contact [student name] OR the project supervisor [name] ([email address]). This research has been approved ([reference number]) by the Sciences & Technology Cross-Schools Research Ethics Committee (C-REC) ( HYPERLINK "mailto:crecscitec@sussex.ac.uk" crecscitec@sussex.ac.uk). The AVƵ has insurance in place to cover its legal liabilities in respect of this study.
Please delete orange sections according to your study.
Please provide missing details in square brackets.
Please ensure participants receive 2 copies of this form: one to sign & return, one to keep.
The first 4 bullet points (including one that is X OR Y) must be included in all applications.
The consent section below must capture all relevant details about how confidentiality/anonymity will be ensured in the collection/storage and publication of your research. You must check this is comprehensive for your needs, and add any missing details.
Data should be stored on a University server/University cloud-based system ie Box (staff and PGRs) and One-Drive (staff and students) this also covers remote working.
If you are gaining consent electronically (by e-mail) or on-line you will need to adapt this section of the consent form. If electronically you can insert a text box that states type name if submitting electronically.
For anonymous on-line surveys you need to gain active consent by adding tick boxes for each of the consent statements you are using and/or an I consent button.
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Sussex Department-School Logos_V.1_25_02
Illustrator
2009-06-09T16:38:25+01:00
2009-06-09T15:38:28Z
2009-06-09T16:38:25+01:00
256
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