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Consent Form Sample

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Claudia Eggers October 8, 2021 Agreement
Today, I will walk students through an example of a consent form that was developed by a group of MPH students. So to begin, you will note that one of the first things that this group did was to put at the top of their Consent Form the title of their studies. So here is the title of their study, and I have gone ahead, and I lighted that for you. So, the title is Health and Work Performance Survey of Savanna-la-mar Division of the Jamaica Constabulary Force. They've also gone ahead and put the name of the investigators. As per the template, it is the Consent Form and this marks the format index that you will need for your Consent Form.
The first section of your Consent Form is the purpose of the study. And in this section, what they've gone ahead and done is they have described, what is the purpose of their study. So, highlighting upfront that this is something being done as a part of a course and not an actual. The next item on the Consent Form is the procedure. The participants have gone, did not the participants rather, but the investigators. I've gone ahead and describe what they're going to do. It's going to be a questionnaire. It's going to be conducted in approximately ten minutes. They have gone ahead, and state that participation is entirely voluntary, and the person can decide if they so choose to withdraw any time.
They do identify some benefits that it does contribute to society gaining new information. And then, they go into describing what are the risk, and this is important. So there are no foreseeable risk involved and participate in the study. And so they conclude that the study poses minimal risk. Okay, one of the thing is in very essential to write that the study pose is minimal risk, cause there's never such a thing as no risk. You might ask somebody about their weight, and they are very emotionally triggered by questions on their weight. And they might just go into an emotional state of, distressed.
Then the other component is confidentiality. Note the participants have given not the participants rather, but the investigators have been given are given the assurance to the participants, that their data will be kept confidential, and only the investigators will be private to this information. They have provided contact information for the principal investigator, who you will name for the purpose of your survey. So, this is the person you can contact. Should you have any question as well as you can add your information to it? Should the person have any questions and choose to contact you.
One of the other things that is very important is the declaration. This is where you are declaring that the person have read and understood, and the voluntarily giving permission to participate in the study. And ensuring them that a copy of the consent form will be given to them, if they so desire to take one.
Following that is the signature page, and this is where you put a number that is a unique identifier for the person, that will connect the consent form to the questionnaire. Because remember the questionnaire will not have a name on it, but rather a number. So for the consent form to be connected to the questionnaire, they both must have the same unique identified. The person who is participated in the study would put their name, their address, their signature, the date and a witness will be given there. Usually ask for a third signature, and that's the signature of the person doing the enrollment. So, when you do your own form, ensure that you have three places for signature, including the enrolled, the participant, and a witness. And those are one of the basics of your constant form.
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