FORM 2.

2
INFORMED CONSENT EVALUATION FORM
(To be filled out by the lead researcher)

Submission Date JULY 22, 2022

Part I. Protocol Profile Protocol Number
Protocol Title
Engagement of Women in Fisheries and Agriculture Sectors:
Basis for Empowerment for the Family and Community Development
Lead Researcher ANGELO B. DALAGUIT

Part V. Informed Consent Evaluation

(To facilitate ease of review, please indicate the specific page number of your research proposal where the answer to each question is found.)
Assessment Points Page No. Comments/Suggestions
(For reviewer's use only)

1
1. Does the ICF state that the procedures are primarily intended for research?

1-2
2. Are procedures for obtaining Informed Consent appropriate?

1-2
3. Does the ICF contain comprehensive and relevant information?

1
4. Is the information provided in the protocol consistent with those in the ICF?

2
5. Are study related risks mentioned in the consent form?

1-2
6. Is the language in the Informed Consent document understandable?

2
7. Are names and contact numbers from the research team and the UREC in the ICF?

1-2
8. Does the ICF provide privacy & confidentiality protection?

9. Is there provision for medical / psychosocial support?

10. Is there provision for treatment of study-related injuries

11. Is the amount paid to participants stated?

12. Are the different types of consent forms (assent, patient representative)
appropriate for the type of study participants?

Decision:
Approved Minor Revision Major Revision Disapproval

Reviewed by:

Member, UREC