Doc menu

Appendix 4 - Consent Form

UNIVERSITY OF HERTFORDSHIRE
FACULTY OF HEALTH & HUMAN SCIENCES
HEALTH AND EMERGENCY PROFESSIONS ETHICS COMMITTEE

CONSENT FORM FOR STUDIES INVOLVING HUMAN SUBJECTS

Title of research project:     

THE EVALUATION OF THE IMPACT OF IMPLEMENTATION OF CONSULTANT PRACITIONERS IN CLINICAL IMAGING

The purpose of this study has been explained to me.   [YES]   [NO]                               

I have been informed of the details of my involvement in the study.   [YES]   [NO]       

My questions regarding this study have been answered to my satisfaction.   [YES]   [NO]

I consent to the audio-taping of the interview in which I am participating.   [YES]   [NO]  

I understand that I am not obliged to take part in this study and may withdraw at any time without the need to justify my decision and without affecting me in any way.   [YES]   [NO]

I understand that any personal information obtained as a result of my participation in this study will be treated as confidential and will not be made publicly available.   [YES]   [NO]

I, the undersigned, agree to take part in this study.   [YES]   [NO]        

Signature of interviewee ..........................................................

Name of interviewee:................................................................
(Please print)

Signature of investigator:.........................................................

Name of investigator:...............................................................
(Please print)

Status of investigator:..............................................................

Date:...............................................

Content tools

Accessibility controls

Text size

AA A

Colour