Participant Identification Number:

 

Name of Researcher:

                                                                                                         Please initial box

1.  I confirm that I have read and understand the information sheet dated XXXX for the above study. I have had the opportunity to consider the information, ask questions and have had these answered satisfactorily.

2.  I understand that my participation is voluntary and that I am free to withdraw at any time, without giving any reason.

3.  I understand that any information given by me may be used in future reports, articles or presentations by the research team.

4.  I understand that my name will not appear in any reports, articles or presentations.

 5.  I agree to take part in the above study.

 

________________________          ________________             ________________
Name of Participant                      Date                                Signature

 

_________________________        ________________             ________________
Researcher                                 Date                                Signature

 

When completed, please return in the envelope provided (if applicable).  One copy will be given to the participant and the original to be kept in the file of the research team at: PLACE

1

CONTACT ADDRESS

 

Factors that promote a positive adjustment to motherhood: Service implications.
Name of Researcher: 

1. I confirm that I have read the information sheet for the above study, understand what it says and have asked any questions I have about the study.
   
   
2. I agree to take part in a one-to-one discussion that will be audio-recorded, transcribed anonymously and used for the purposes of research.
   
   
3. I agree that the audio-recording of the interview will be stored securely for publication purposes.
   
   
4. I understand that my participation is voluntary and that I am free to withdraw at any time either before or during the research interview and during the two week cooling off period following interview, without giving any reason, and without any services I currently receive, or will receive in the future, being affected.

Name of Participant:                 Date:                      Signature:
_______________________    ___________         ___________________________
Name of Researcher:                Date:                      Signature:
_______________________    ___________         ___________________________

 

Address

Participant reply form – please complete if you are happy for the research investigator to contact you.

Title of Study:  Understanding self-care in diabetes: A qualitative study of peoples’ experiences.

 

Name of Researcher:

Please tick the box

1. I confirm that I have read and understand the research information                             
   sheet for the above study and have had the opportunity to ask questions.
   
   
2. I understand that my participation is voluntary and that I am free to                           
   withdraw at any time, without giving any reason and without my medical
   care or legal rights being affected.
   
   
3. I understand that the above researcher from the University of Lancaster                       
   who is working on the project will have access to my personal details.
   
   
4. I understand that any data or information used in any publications                              
   which arise from this study will be anonymous  
   
   
5. I understand that all data will be stored securely and is covered by the                        
   data protection act.
   
   
6. I agree that the researcher can contact me on the below telephone number                  
   to arrange an interview at a time and location to suit me.

Name of Participant		Date		Signature
Contact telephone number:

 

 

Contact Address:

Informed consent form – please complete if you are happy to take part in the study.

Title of Study: 

Understanding self-care in diabetes: A qualitative study of peoples’ experiences.

Name of Researcher:

Please tick the box

1. I confirm that I have read and understand the research information                              
   sheet for the above study.  
2. I have spoken to the above researcher and understand that my                                    
   involvement will involve being interviewed at a time and place to suit me. I have had the opportunity to ask questions
3. I understand that my participation is voluntary and that I am free                                 
   to withdraw at any time, without giving any reason and without my medical care or legal rights being affected.  
4. I understand that the above researcher from the University of                                       
   Lancaster who is working on the project will have access to my personal details.  
5. I understand that any data or information used in any publications                                
   which arise from this study will be anonymous.
6. I understand that all data will be stored securely and is covered by                               
   the data protection act.
    I agree to take part in the above study.

Name of Participant		Date		Signature

 

 

Contact Address:

Title of Study:  Understanding self-care in diabetes: A qualitative study of peoples’ experiences.

Name of Researcher:

Please tick the box

1. I would like to receive a summary report of the study and am happy                              
   for the researcher to store my address details on a secured server in
   order to post the report to me when it is available.
2. I agree to being contacted again for a second interview should the                                
   need arise.

 

Name of Participant		Date		Signature

 

Dear Parent/Guardian

Re: Project -

Who am I?

My name is xxxx  and I am training to be a xxxxxx. I am doing a project about how young people with learning disabilities see themselves in terms of their identity. I would really appreciate your help with this project by allowing me to talk to your son or daughter about how he or she describes who he/she is.

I have planned to talk to each pupil who takes part for up to an hour, depending on each individual. I will tape record the interview to help me remember what they have said and to help me write a report. However, the interviews will be confidential and the only people who listen to the interview will be myself, my supervisors and my examiner, who will be checking my work. No-one will be named in the report.

If you are happy for your son or daughter to take part, I would be very grateful if you could sign the attached form and return it to school.

If you would like to know more about the project, please contact either me or the headteacher at the school at the above addresses.

Many thanks for taking the time to read this letter and for your help.

Yours sincerely

 

I am happy to let my son/daughter* (print name)……………............…take part in the project “Who am I?”

• I agree that the interview can be recorded.
• I understand that the interview will be confidential.
• I understand that my son/daughter can stop the interview at any time.
• I understand that if my son/daughter does not want to take part, it will not affect him/her if help is needed in the future.

 

Signed…………………………………………Parent/Guardian

Please print your name…………………………

Please return this form to school as soon as possible

 

 

CONTACT ADDRESS

 

Re: “Who am I?” Project:

Dear Parent/Guardian

My name is xxxx and I am training to be a clinical psychologist. I am doing a research project as part of my training about how young people with learning disabilities see themselves in terms of their identity. Studies show that adolescence is a key time in identity construction and thinking about personal identity is seen as good practice in special education when young people are moving into adulthood. Being aware of who they are has been shown to enable young people to make positive choices about what they would like to do next. Other studies show that having a stable identity may be beneficial to mental wellbeing. I would really appreciate your help with this project by allowing me to talk to your son or daughter about how he or she would describe himself/herself.

I have planned to talk to each pupil who takes part for up to an hour, depending on each individual. The interview will include questions around how the young people might describe themselves, how others might describe them and what they think about the label of learning disability. I plan to tape record the interview to help me remember what they have said and to help me write a report. However, the interviews will be confidential and the only people who listen to the interview will be myself, my research supervisors and my examiner, who will be checking my work. No-one will be named in the report.

The head-teacher of the school is interested in and willing to cooperate with my research and has identified young people who she feels would be able and interested in taking part. The study has been approved by the ethics committee at Lancaster University.

I have asked the young people themselves for consent to being interviewed and have attached the information sheet for your information. I and staff who know your son/daughter well have spent some time explaining the study to them. You son/daughter has expressed an interest in taking part in the study and has completed a consent form (enclosed). If you are not willing to agree to your son or daughter taking part, I would be very grateful if you could sign the attached form and return it to school. If you would like to know more about the project, I would be very happy to chat with you. If you wish to do this, please feel free to contact either the head teacher at the school or me at the above addresses.

Many thanks for taking the time to read this letter and for your help.

Yours sincerely
.

 

Re: “Who Am I?” Project

I am aware that my child * (print name)…………………..…has agreed to take part in your project “Who am I?”

I do not wish my child to take part in the project.

Signed…………………………………………Parent/Guardian

Please print your name…………………………

 

Please return this form to school as soon as possible

 

 

Project - Who am I?

 

My name is xxxxx and I am studying to be a psychologist and I am doing a project for my course.

I would really like to hear about how you would describe yourself and what other people might say about you.

                                     

 

Our talk would be private. I will not tell your teachers or your family what you say.

                                                    

Insert picture of researcher here.

You can ask for the interview to stop at any time. It will take no longer than one hour.

                                              

You can say yes or no. It is up to you whether you take part.

                                             

If you do want to take part, please ask someone to help you read the form

                                             

If you would like to talk to me, I would be very grateful if you could sign the attached form and return it to school.

                                                  

If you would like to know more about the project, please contact either me or the headteacher at the school at the above addresses.

                                                  

Thank you for taking the time to read this letter and for your help.

                                                

Yours sincerely

 

If I talk to xxxx about her project “Who Am I?”

• I understand that the interview will be recorded.

                                             

• I understand that the interview will be private.

                                                 

• I understand that I can stop the interview at any time.

                                                  

If you understand the statements above, you now need to decide whether you would like to take part in the project.

I have decided that I would like to talk to Lesley about her project “Who am I?”

Please put a circle round No or Yes.

                                                                        
                               No                                                                     Yes

Signed…………………………………………

Please print your name…………………………

Please return this form to school as soon as possible

                                                      

 

 

Participant Identification Number:

Consent form – protocol 1 (DATE)

Adolescents’ Experience of Using a Specialist Mental Health Service

Please put your initials

  

1. I have read and understood the ‘Information about the research’ sheet dated 07/07/09 (version 2) for this study. I have had the opportunity to consider the information and ask questions.
2. I understand that taking part is entirely voluntary and that I am free to change my mind and withdraw at any time, without giving any reason.
3. I agree to being interviewed and the interview being tape recorded.
4. I agree that (anonymous) quotes from my interview may be used in the write up of the study and may be published.
5. I would like to receive a summary of the results.
6. I agree to take part in this study.

 

_________________                      ____________         _________________
Your name                                         Date                            Your Signature

_________________                      ____________         _________________
Researcher Name                            Date                            Researcher Signature

 

(1 for participant and 1 for researcher)