PARTICIPANT CONSENT FORM
Th
The form must be on Anglia Ruskin University headed notepaper or have the Anglia Ruskin
University logo as the header.
Undergraduate and Masters students are strongly advised to use this as a template.
Not all the below statements may be applicable to your research and you may need to add
others.
NAME OF PARTICIPANT:
Title of the project:
Main investigator and contact details:
Members of the research team:
1.
I agree to take part in the above research. I have read the Participant Information
Sheet (add date and version number of Participant Information Sheet) for the study.
I understand what my role will be in this research, and all my questions have been
answered to my satisfaction.
2.
I understand that I am free to withdraw from the research at any time, without giving a
reason.
3.
I am free to ask any questions at any time before and during the study.
4
I understand what will happen to the data collected from me for the research.
5.
I have been provided with a copy of this form and the Participant Information Sheet.
6.
I understand that quotes from me will be used in the dissemination of the research
(delete as applicable).
7.
I understand that the interview will be recorded (delete as applicable).
Data Protection: I agree to the University1 processing personal data which I have supplied. I
agree to the processing of such data for any purposes connected with the Research Project
as outlined to me*
Name of participant (print)…………………………Signed………………..….Date………………
Name of person
witnessing consent (print)………………………….Signed………………….. Date………………
1
“The University” includes Anglia Ruskin University and its Associate Colleges.
PARTICIPANTS MUST BE GIVEN A COPY OF THIS FORM TO KEEP
ADD DATE AND VERSION NUMBER OF CONSENT FORM.
-------------------------------------------------------------------------------------------------------------------------I WISH TO WITHDRAW FROM THIS STUDY.
If you wish to withdraw from the research, please speak to the researcher or email
them at (add email address) stating the title of the research.
You do not have to give a reason for why you would like to withdraw.
Please let the researcher know whether you are/are not happy for them to use any
data from you collected to date in the write up and dissemination of the research.
Date 8.2.16
V1.1