WG3.

4: Ethics issues (legal elements) in H2020

Actions pre- and post-award phases
Part 2 – Case studies

Ethics Supporting Documents

Fatma Uslu

Cukurova University, Adana

 Cukurova University Project Development and Coordination Office

The main objective of Project Development and Coordination Office (PDCO) is

providing support research at Cukurova University to reach its strategic targets and
implement internal policies.

Responsibilities
• Informing all faculties and researchers about project calls and funding opportunities
• Supporting or directing the process through formal submission, developing budgets
and overseeing completion of forms and documents
• Reviewing grant and contract proposals for accuracy, completeness and compliance
with agency regulations and institutional policies
• Providing ongoing trainings, seminars, workshops for academic and administrative
staff on the development and preparation of grants and related matters.
Table of Content
• Ethics Issues Checklist

• Ethics Self-Assesment

• Ethics Self-Assesment Forms Sample

• Ethics Supporting Documents Prepared for WoMUNE

Ethics and Security

If we have entered any ethics issues in the ethical issue table in the
administrative proposal forms, we need to

• Submit an ethics self-assesment

• Provide the documents that you need under national law
Ethics Issues Table

Ethics Issues Table - Checklist

Ethics self-assesment
Explains in detail how you intend to address the issues in the ethical issues table, in
particular as regards:

-research objectives (e.g. study of vulnerable populations, dual use, etc.)

-research methodology (e.g. clinical trials, involvement of children and

related consent procedures, protection of any data collected, etc.)

-the potential impact of the research (e.g. dual use issues, environmental
damage, stigmatisation of particular social groups, political or financial
retaliation, benefit-sharing, malevolent use , etc.).
Ethics self-assesment
If your proposal raises one of the issues listed in the ethics issue checklist above,
you must proceed to the ethics self-assessment in Part B of your proposal.

Your proposal must include the information indicated in the ethics issues checklist
and any of the documents that are already available. ( For documents that are not
yet available, provide an approximate timeline for their submission.)

The ethics self-assessment will become part of your grant agreement.

Ethics self-assesment
• Improve your research results
• Make the proposed research applicable international and national law
• Provide the results of the research more easily published in internationally
refereed journals
Ethics self-assesment form

Describes how the proposal meets the national legal and ethical
requirements of the country or countries where the tasks raising
ethical issues are to be carried out.
Ethics Self Assesment Form Sample

Sample of the Proposal «Women Mobilising

University Networks in Europe-WoMUNE»
Liverpool John Moores & Cukurova University
Ethics Supporting Documents Prepared for
WoMUNE

• E-mail Invitation to Complete Survey

• Participant Consent Form

 Annex 2: ETHICS ISSUES TABLE - CHECKLIST
DISCLAIMER: This document is intended as useful information for applicants. The applicants have to check with their local structures
(ethics committees, data protection officers, ethics experts) for relevant and detailed guidance.

This document summarizes potential ethics issues that a proposal could raise, as well as guidance on the information to be provided in the
proposal (Part B section 6) in order to complete the ethics self-assessment. The last column of the table focuses on the documents to be provided
– when relevant, should the proposal be selected for funding.

Section 1: HUMAN EMBRYOS/FOETUSES YES/NO Page Information to be Documents to be provided

provided
Does your research involve Human Embryonic Stem Cells (hESCs)?1
- Will they be directly derived from embryos within this project? Research cannot be Research cannot be funded.
If YES: funded.

- Are they previously established cells lines? Origin and line of cells. Copies of relevant Ethics Approvals.
Details on licensing and
control measures by the
competent authorities of
the Member States
involved.
Does your research involve the use of human embryos? Origin of embryos. Copies of relevant Ethics Approvals.
If YES: Details on recruitment, Informed Consent Forms.
inclusion and exclusion
Information Sheets.
criteria and informed
consent procedures.
Does your research involve the use of human foetal tissues / cells? Origin of human foetal Copies of relevant Ethics Approvals.
tissues/cells. Informed Consent Forms.
If YES:
Details on informed
Information Sheets.
consent procedures.
 Section 2: HUMANS YES/ NO Page
Information to be provided Documents to be provided
Does your research involve human participants? Please provide information in
one of the subcategories below:

- Are they volunteers for social or human sciences research? Details on recruitment, Copies of relevant Ethics Approvals.
If inclusion and exclusion
YES: Informed Consent Forms.
criteria and informed consent
procedures. Information Sheets.
- Are they persons unable to give informed consent? Information above plus: Documents as above.
Details on the procedures to
obtain approval from
guardian/ legal
representative.
Details on the procedures
used to ensure that there is no
coercion on participants.

- Are they vulnerable individuals or groups? Details on the type of Documents as above.
vulnerability.
Details on recruitment,
inclusion and exclusion
criteria and informed consent
procedures. This must
demonstrate appropriate
efforts to ensure fully
informed understanding of
the implications of
participation.
- Are they children/minors? Information above plus: Documents as above.
Details on the age range.
Details on children/minors
assent procedures and
parental consent. This must
demonstrate appropriate
efforts to ensure fully
1
 informed understanding of
the implications of
participation.
Describe the procedures to
ensure welfare of the
child/minor.
- Are they patients? Details on the nature of Documents as above.
disease/condition/disability.
Details on recruitment,
inclusion and exclusion
criteria and informed consent
procedures
Details on policy for incidental
findings.
- Are they healthy volunteers for medical studies? Information as above Copies of relevant Ethics Approvals.

Does your research involve physical interventions on the study

participants?
If - Does it involve invasive techniques (e.g. collection of Risk assessment for each Copies of relevant Ethics Approvals.
YES: human cells or tissues, surgical or medical interventions, technique and as a whole
invasive studies on the brain, TMS etc.)?
- Does it involve collection of biological samples? Details on the type of samples Copies of relevant Ethics Approvals.
to be collected.

Details on procedures for

collection of biological
samples.
If your research involves processing of genetic information, please also complete the section “Protection of Personal Data” i.e. Section 4.

2
 Section 3: HUMAN CELLS / TISSUES YES/ NO Page Information to be provided
Does your research involve human cells or tissues? (Other than from Details of the cells and tissue
“Human Embryos/Foetuses” i.e. Section 1) types involved.
- Are they available commercially? Details on cell types and
If YES: provider (company or
other).
- Are they obtained within this project? Details on cell types.
- Are they obtained within another project? Details on cell types.
Provider of the cell types.
Country in which the
material is located.
- Are they deposited in a biobank? Details on cell types.
Name of the biobank.
Country in which the
biobank is located
Documents to be provided
Any relevant import licences
Copies of relevant Ethics Approvals or
regulatory licences.
Copies of examples of Informed
Consent documents.
Authorisation by primary owner of
cells/tissues (including references to
relevant licences or ethics approval
and evidence of consent for secondary
use).
Copy of any Material Transfer
Agreement.
Details of the biobank, the legislation
under which it is licenced, criteria for
access and its data protection policy
including any Material Transfer
Agreement.
3
 Section 4: PROTECTION OF PERSONAL DATA2 YES/NO Page Information to be Documents to be provided
provided
Does your research involve personal data collection and/or
processing?

It should be noted that:

1. “Personal data” can be defined as identifiers: any information that could,
in any way, lead to the specific identification of one unique person, such as
name, social security numbers, date of birth, address, mails IPs etc.

2. Any data that you are using should be taken into account, regardless of
the method by which they are/were collected: for example, through
interviews, questionnaires, direct online retrieval etc.

3. Processing should be understood to not only include data usage, but also
merging, transformation, transfer and, more generally, as all actions using
data for research purposes.

4
 - Does it involve the collection and/or processing of sensitive Details of the data safety Copies of relevant Ethics Approvals for
If YES: personal data (e.g. health, sexual lifestyle, ethnicity, political procedures (compliance the collection and/or processing of
opinion, religious or philosophical conviction)? with privacy by design personal data.
and protection of
privacy/confidentiality). If relevant, Informed Consent Forms
It should be noted that this involvement applies, whatever the or other consent documents (opt in
research topic or Programme. The above list is only indicative. If Details of procedures for processes, etc.).
the type of data that you will be handling in your research is not data collection, storage,
included the list, it does not mean you should not take into protection, retention, If relevant, Information Sheets or
consideration the subject of data processing. transfer if any, other terms and conditions, factsheets,
destruction or re-use. etc.

Explicit confirmation of If relevant, notification to, or

compliance with national authorisation from, the relevant Data
and EU legislation. Protection Authority/Officer.

If relevant, a copy of authorization to

merge the data sets in order to create
a novel data set.
- Does it involve processing of genetic information? Information as above. Copies of relevant Ethics Approvals for
the processing of genetic information.
- Does it involve tracking or observation of participants? Information above plus: Copies of relevant Ethics Approvals for
the collection and/or processing of
It should be noted that this issue is not limited to surveillance or Details on methods used personal data.
localization data. It also applies to Wan data such as IP address, for tracking or observing
MACs, cookies etc. participants.

Does your research involve further processing of previously Details of the database Explicit confirmation of open public
collected personal data (secondary use)? used or to the source of access to the data (e.g. print screen
data. from Website) or authorisation by
If YES: primary owner(s) of data.
Confirmation of open
It should be noted that this question is threefold. If you answer YES to any of public access to the data If relevant/applicable, copies of
the 3 questions below, you fall within its scope: or of authorisation for Informed Consent Forms or other
secondary use. More consent documents (opt in processes,
1. Are you planning not to collect any data directly but rather to use pre- specifically, detail how etc.).
existing other data sets or sources and/or does your research involve further this consent was obtained
processing of previously collected data? specifically in case of Copies of relevant permissions and
public archives usage description of procedures.
2. Does your research involve merging existing data sets?
(automatic opt in, etc.).

5

3. Are you planning to share data with non-EU member states?
Permissions from the
owner/manager of the
data sets.
A mitigation procedure to
avoid private
appropriation of the data.
If data transfer to USA/Canada:
confirmation of compliance with safe
harbour.
If data transfer to non-EU country,
affidavit of compliance with EU
legislation.

A mitigation procedure to
avoid the unforeseen
disclosure of personal
information (i.e.: mosaic
effect).

Explicit confirmation of
compliance with national
and EU legislation.

Conformity to Safe
Harbour, if applicable.

Section 5: ANIMALS3 YES/NO Page Information to be provided Documents to be provided

Does your research involve animals? Details on implementation Copies of all appropriate
of the Three Rs authorisations for the supply of
(Replacement, Reduction animals and the project experiments.
and Refinement). Copies of training certificates/
Justification of animal use personal licences of the staff
and why alternatives involved in animal experiments.
cannot be used.
Confirmation of compliance with
Details on species and relevant EU and national legislation.
rationale for their use,
numbers of animals to be
used, nature of the
experiments, procedures
and techniques to be used

6

- Are they vertebrates or live cephalopods?
If YES:
- Are they non-human primates (NHP)?
- Are they genetically modified?4
- Are they cloned farm animals?
in a chronological order.
Details on procedures to
ensure animal welfare
during their lifetime and
during the experiment and
how its impact will be
minimised.
Details on severity
assessment and
justification.
Information as above.
Information above plus:
Confirmation of
compliance with Art. 8, 10,
28, 31, 32 (Directive
2010/63/EU).
Discussion of specific
ethics issues related to
their use.
Confirmation of
compliance with relevant
EU and national legislation
and details as for non-
genetically modified
animals above.
Information as above
Documents as above.
(See Art. 1.3 of Directive
2010/63/EU).
Documents as above.
Personal history file of NHP
(See Art. 31.2 of Directive
2010/63/EU).
Copies of all appropriate
authorisations for the supply of
animals and the project experiments,
copies of GMO authorisation and
evidence of compliance with GMO
Regulations, and supporting
documents as for other experimental
animals.
Copies of training certificates/
personal licences of the staff
involved in animal experiments
Copies of all appropriate
authorisations for the supply of
animals and the project experiments
as for other experimental animals.
7

- Are they an endangered species? Information above plus:
Discussion of specific
ethics issues related to
their use.
Please indicate the species involved (Maximum number of characters allowed: 1000)
Section 6: THIRD COUNTRIES YES/ NO Page Information to be provided
Does your research involve third countries? Details on activities carried
Countries:(Maximum number of characters allowed: 1000) out in non-EU countries.
Do you plan to use local resources (e.g. animal and/or human tissue Details on type of local
samples, genetic material, live animals, human remains, materials of resources to be used and
historical value, endangered fauna or flora samples, etc.)? modalities for their use.
If YES:
Do you plan to import any material, including personal data, from non- Details on type of materials
EU/third countries into the EU? or data to be imported.
If your research involves importing data, please also complete the section
Copies of training certificates/
personal licences of the staff
involved in animal experiments.
Copies of specific authorisation for
cloning, if appropriate.
Copies of all appropriate
authorisations for the supply of
animals and the project experiments
as for other experimental animals,
including CITES.
Confirmation of compliance with Art.
7 - Directive 2010/63/EU.
Documents to be provided
Copies of relevant Ethics Approvals
from EU country host and non-EU
country (double Ethics Review).
If human resources are involved,
copies of relevant Ethics Approvals, as
above.
If animals, plants, micro-organisms
and associated traditional knowledge
are involved, documentation
demonstrating compliance with the
Convention on Biodiversity (e.g.
access permit and benefit sharing
agreement)
As above (use of local resources) and:
Material Transfer Agreement (MTA)
and copies of any authorisations.
8
“Protection of Personal Data” i.e. Section 4.

Specify the materials and countries involved (maximum number of

If YES: characters allowed: 1000)

Do you plan to export any material, including personal data, from the EU Details on type of materials Authorisation for export from EU.
to third/non-EU countries? or data to be exported. Material Transfer Agreement (MTA).

If your research involves exporting data, please also complete the section
“Protection of Personal Data” i.e. Section 4.
If YES: - Specify material and countries involved (maximum number of
characters allowed: 1000)
If your research involves low and/or lower-middle income countries, are Details on benefit sharing As above (use of local resources) and
any benefit-sharing actions planned? measures. narrative document describing benefit
sharing, responsiveness to local
Details on responsiveness research needs and capacity building.
to local research needs.

Details on procedures to
facilitate effective capacity
building.

Could the situation in the country put the individuals taking part in the Details on safety measures Insurance cover
research at risk? that will be implemented,
including personnel
training.

9
 Section 7: ENVIRONMENTAL PROTECTION AND SAFETY YES/ NO Page Information to be Documents to be provided
provided
Does your research involve the use of elements that may cause harm to Details on safety Safety classification of laboratory.
the environment, animals or plants? measures to be GMO authorisation, if applicable.
If YES: implemented.
Confirmation of compliance with
national/local
guidelines/legislation.

Does your research deal with endangered fauna and/or flora Specific approvals, if applicable.
/protected areas?
If YES: Confirmation of compliance with
national/local
guidelines/legislation.

Does your research involve the use of elements that may cause harm to Details on health and University/Research organisation
humans, including research staff? safety procedures. safety procedures.
If YES:
Safety classification of laboratory.
Does your research involve the use of elements that may cause harm to Details on health and University/Research organisation
humans, including research staff? safety procedures. safety procedures.

If YES Does your research involve harmful biological agents?5 Safety classification of laboratory.
Confirmation of compliance with
Does your research involve harmful chemical and explosive national/local guidelines/legislation
agents?6

Does your research involve harmful radioactive agents?7

Does your research involve other harmful materials or equipment,

e.g. high-powered laser systems?

10
 Section 8: DUAL USE 8 YES/NO Page Information to be provided
Does your research have the potential for military applications?
If YES Does your research have an exclusive civilian application focus? Explanations on the
exclusive civilian focus of the
research
Will your research use or produce goods or information that Details on what goods and
will require export licenses in accordance with legislation on information used and
dual use items? produced in your research
will need export licences
Does your research affect current standards in military ethics – Details on how the research
e.g., global ban on weapons of mass destruction, issues of might affect current
proportionality, discrimination of combatants and standards in military ethics.
accountability in drone and autonomous robotics
developments, incendiary or laser weapons?
Documents to be provided
Confirmation that the inclusion of
military partners and technologies
relates to civilian applications e.g.
in the context of law enforcement
activities.
Copies of relevant approvals from
national export control authorities,
if applicable.
A detailed description on what risk
mitigation strategies will be
implemented to avoid negative
implications on military ethics
standards outlined in international
humanitarian law.
11
 Section 9: MISUSE YES/NO Page Information to be provided
Does your research have the potential for malevolent/criminal/terrorist
abuse?
If YES Does your research involve information on/or the use of Details on the legal
biological-, chemical-, nuclear/radiological-security sensitive requirements of the
materials and explosives, and means of their delivery? possession of such items
and proposed risk
mitigation strategies.
Does your research involve the development of technologies or Details on measures to
the creation of information that could have severe negative prevent malevolent abuse.
impacts on human rights standards (e.g. privacy, stigmatization,
discrimination), if misapplied? Details on risk mitigation
strategies.
Does your research have the potential for terrorist or criminal Details on measures to
abuse e.g. infrastructural vulnerability studies, cybersecurity prevent malevolent abuse.
related research?
Details on risk mitigation
strategies.
SECTION 10: OTHER ETHICS ISSUES YES/ NO Page Information to be provided
Are there any other ethics issues that should be taken into consideration? Any relevant information.
Please specify: (Maximum number of characters allowed: 1000)
References to legislation and guidelines
Documents to be provided
Copies of relevant Approvals, if
applicable.
Copies of personnel security
clearances, if applicable
Copies of relevant Ethics Approvals,
if applicable.
Copies of relevant Ethics Approvals,
if applicable.
Copies of personnel security
clearances, if applicable.
Documents to be provided
Any relevant document.
12
1. Regulation of the European Parliament and of the Council laying down the rules for the participation and dissemination in 'Horizon 2020 –
the Framework Programme for Research and Innovation (2014-2020).
Regulation of the European Parliament and of the Council establishing Horizon 2020 - The Framework Programme for Research and Innovation
(2014-2020).
2. Directive 95/46/EC of the European Parliament and of the Council of 24 October 1995 on the protection of individuals with regard to the
processing of personal data and on the free movement of such data.
3. Directive 2010/63/EU of the European Parliament and of the Council of 22 September 2010 on the protection of animals used for scientific
purposes.
4. Directive 2009/41/EC of the European Parliament and of the Council of 6 May 2009 on the contained use of genetically modified
microorganisms.
Regulation (EC) No 1946/2003 of the European Parliament and of the Council of 15 July 2003 on trans boundary movements of genetically
modified organisms – see specifically its articles 4 to 11 and its annexes III to V.
5. Directive 2009/41/EC and Regulation (EC) No 1946/2003.
6. Regulation (EC) No 1907/2006.
7. Directive 96/29/Euratom, Directive 97/43/Euratom, Directive 2006/117/EU, Directive 2003/122/Euratom.
8. Regulation of the European Parliament and of the Council establishing Horizon 2020 - The Framework Programme for Research and
Innovation (2014-2020).
Council Regulation (EC) No 428/2009 of 5 May 2009 setting up a Community regime for the control of exports, transfer, brokering and transit of
dual-use items.
Biological and Toxin Weapons Convention 1972.
Chemical Weapons Convention 1992.
Non-Proliferation Treaty 1968.
Directive 2008/56/EC; Council Directive 92/43/EEC; Council Directive 79/409/EEC.
Council Regulation (EC) No 338/97.
Council Decision 93/626/EEC.
Council Decision 2002/628/EC.
Directive 2009/41/EC and Regulation (EC) No 1946/2003.
Regulation (EC) No 1907/2006.

13
Section 5: Ethics and Security

5.1 Ethics

This section will address the ethical issues regarding the following adequately:

(1) Involvement of human participants

(2) Collection of personal data
(3) Other ethic issues related to privacy of third parties and handling of network data

Supporting documents include:

1. Completed LJMU Ethics Application Form (page 1)
2. Survey Participation Information in an email invitation (page 17)
3. Interview Participation Information Sheet (page 18)
4. Participant Consent Form (page 20)
5. Sample Interview Schedule (will be further development based on all partners
input, page 21)
6. Survey Questionnaire (will be further development based on all partners input,
page 22)

Ethical aspects of WoMUNE’s research methods have been considered and will be
addressed by implementing the following measures:

1. Participation to the survey is entirely voluntarily. A participant information sheet and

consent form will be provided to fully inform potential participants of the aims and objectives
of the study (See Participant Information Sheet and Consent Form).

2. The questions in the questionnaire which are based on pre-existing surveys have
been adapted to reflect the academic context of UK universities and research institutions
(See Questionnaire).

3. Some interview questions have been provided in the participant information sheet
to inform participation.

4. Potential participants will be given sufficient time to think about taking part in the
research.

The following Code of Ethics will be strictly adhered to throughout the research process:
Informed consents of participants will be obtained before involving them in the study.
The process of recruiting participants will not involve coercion in any way.
The protection of privacy of the research participants, including third parties, will be
ensured.
Participation in surveys and in-depth interviews will be voluntary.
Adequate level of confidentiality of the research data will be ensured.
Anonymity of individuals and organisations participating in the research will be ensured.
Affiliations in any forms, sources of funding, as well as any possible conflicts of interests
will be declared.
The research will be communicated with honesty and transparency at all levels.
Misleading and biased representation of data and findings will be avoided.
Falsification, fabrication and misinterpretation of data will be avoided at all times.
Works of other researchers and authors used in research will be referenced.

Hence, ethical consideration is not a task completed upon the approval of the ethics
application. It is a process that has to be revisited all throughout the study. This is particularly
important in relation to network data where participants may be identified based on their ego-
networks, particularly in WP5. This will be monitored carefully and will be noted in reporting
findings and publications without misrepresentation or misinterpretation of the network data
collected.

INFORMED CONSENT DATA ARCHIVING AND SHARING

WoMUNE is designed to primarily collect survey and interview data. The Project Coordinator
and WP leaders will comply with the legal and ethical requirements existing in the relevant
research sites. Collaborators from each of the research sites will provide guidance to ensure
compliance to local ethical guidelines and obtain approval before engaging any full-time
academics and researchers. The project will obtain informed consent from participants to
participate in each of the relevant work packages for use of the information collected.
Consent will also provide a clear statement relating to data archiving and sharing or any
other future uses of data. The consent form will provide sufficient information for clarity and
explicit description of data management in terms of how research data will be stored,
preserved and used in the long-term; and how confidentiality will be maintained, e.g. by
anonymising data; how data will be shared where anonymisation is not desirable, e.g.
network data. Participant’s consent to use data unaltered will be explicitly sought and data
protection will be exercised with additional access controls on the data, if necessary.

Responsibility: LJMU will have overall responsibility for data management over the course of
the research project and will monitor compliance with the project plan. The coordinator will
ensure that the research data is managed in complete compliance with European
Commission’s Research Data Management Policy and guidelines.

Access and Sharing: Data will be available via the project website. Standard identifiers and
formats will be agreed and used to facilitate data management.

Ethics and Privacy: Whether or not required as a condition of Research Ethics approval, all
data will be de-identified before long-term storage and sharing with the research community.
The information sheet and consent form for this programme will clearly state that the data will
be imported or exported from/to the host site from/to the different research sites.

Storage and Backup: To ensure on-going and long-term security of the data generated by
this project, a complete (master) copy of each digital file (i.e., research data files,
documentation, and other related files) will be generated and stored independently on
primary and backup sources at LJMU’s archival storage.

Archiving and Preservation: On completion of WoMUNE, the PI will identify which project
materials are of probable long-term interest for archiving and preservation. Materials will be
anonymised or de-identified as appropriate, converted to searchable pdf document format,
and stored locally. Data will be retained for 10 years. LJMU will archive the full dataset and
its documentation for the long term, supporting the data through changing technologies, new
media, and data formats. The opportunity to participate in open data access will be
considered.
EMAIL INVITATION TO COMPLETE SURVEY

Dear Colleague,

I am writing to ask you to take part in a survey which seeks to understand the
network relations and networking behaviours that create and influence the academic
climate at your institution that either facilitates or inhibits the advancement of female
academics. Network relations include mentoring schemes, informal meetings and
social gatherings.

The research covers all full-time academics and researchers in all disciplines. It is not
only targeting female colleagues in anyway. The academic climate is sustained by
both genders. All of the responses will be treated in the strictest confidence and will
be used for academic purposes only. All data collected as part of this survey will be
stored in anonymised form.

If at any point you find any of the questions upsetting for any reason, you may
choose to discontinue from completing the survey.

Completing the survey should take no more than 15 minutes. If you have any queries,
please feel free to contact me at j.g.enriquezgibson@ljmu.ac.uk.

We realise the great pressures on your time and would like to thank you in advance
for taking the trouble to read this e-mail and, we hope, to complete the survey.

PLEASE FOLLOW THIS LINK TO TAKE THE SURVEY

Yours sincerely
Judith Enriquez-Gibson
 CONSENT FORM

Women Mobilising in University Networks in Europe

Judith Enriquez-Gibson, School of Education

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

I understand that my participation is voluntary and that I am free to withdraw at

any time, without giving a reason and that this will not affect my legal rights.

I understand that any personal information collected during the study will be
anonymised and remain confidential.

I agree to take part in an interview for the above study.

I understand that the interview will be audio recorded and I am happy to

proceed.

I understand that parts of our conversation may be used verbatim in future

publications or presentations but that such quotes will be anonymised.

Name of Participant Date Signature

Name of Researcher Date Signature

Name of Person taking consent (if different from researcher) Date Signature

Note: When completed 1 copy for participant and 1 copy for researcher.