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PHPC3027 Consent Form Interviewee1

This document outlines the consent form for a participant in a research study addressing health literacy in dermatology. The participant agrees to voluntarily participate and can withdraw at any time without consequences. They understand they will complete a health literacy questionnaire and interview about personal experiences with dermatological issues. The participant agrees for the anonymous use of their interview in presenting research findings and understands signed forms and recordings will be securely stored for a limited time period.

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陳順玲
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53 views2 pages

PHPC3027 Consent Form Interviewee1

This document outlines the consent form for a participant in a research study addressing health literacy in dermatology. The participant agrees to voluntarily participate and can withdraw at any time without consequences. They understand they will complete a health literacy questionnaire and interview about personal experiences with dermatological issues. The participant agrees for the anonymous use of their interview in presenting research findings and understands signed forms and recordings will be securely stored for a limited time period.

Uploaded by

陳順玲
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Addressing health literacy(HL) in dermatology

Consent to take part in research

⚫ I LAM Lok Wan voluntarily agree to participate in this research study.


⚫ I understand that even if I agree to participate now, I can withdraw at any time or refuse to
answer any question without any consequences of any kind.
⚫ I understand that I can withdraw permission to use data from my interview within one weeks
after the interview, in which case the material will be deleted.
⚫ I have had the purpose and nature of the study explained to me in writing and I have had the
opportunity to ask questions about the study.
⚫ I understand that participation involves conducting a questionnaire in measuring my own HL
level and interview about my personal experiences and view towards dermatological problems.
⚫ I understand that I will not benefit directly from participating in this research.
⚫ I agree to my interview being audio-recorded.
⚫ I understand that all information I provide for this study will be treated confidentially.
⚫ I understand that in any report on the results of this research my identity will remain
anonymous. This will be done by changing my name and disguising any details of my interview
which may reveal my identity or the identity of people I speak about.
⚫ I understand that disguised extracts from my interview may be quoted in the PHPC3027
research presentation only.
⚫ I understand that if I inform the researcher that myself or someone else is at risk of harm they
may have to report this to the relevant authorities - they will discuss this with me first but may
be required to report with or without my permission.
⚫ I understand that signed consent forms and original video recordings will be retained in an USB
with encryption. Only the researchers with passwords can browse the data and recording saved
in the USB until 31/12/2021.
⚫ I understand that a transcript of my interview in which all identifying information has been
removed will be retained for two months.
⚫ I understand that under freedom of information legalization I am entitled to access the
information I have provided at any time while it is in storage as specified above.
⚫ I understand that I am free to contact any of the people involved in the research to seek further
clarification and information.
Names, degrees, affiliations and contact details of researchers (and academic supervisors when relevant).

Signature of research participant

Signature of participant Date:


16/11/2021

Signature of researcher
I believe the participant is giving informed consent to participate in this study

Signature of researcher Date:


16/11/2021

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