Kumbotso Consent 2

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APPENDIX-III: CONSENT FORM

Acceptance to participate in the study

By signing this form, I certify the following:

1. I have carefully read and understood the content in the information sheet and have taken
enough time to consider my participation in the study.

2. I voluntarily agree to participate in the study and provide the researcher with all the necessary
information he may require.

3. I agree that my personal information will not be published at any time in the manner which
can identify me.

4. I am aware that I may quit from participating in the study at any time.

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Name of the respondent Signature I/C No.

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Name of the researcher Signature I/C No

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