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Appendix A Sample Informed Consent Form Informed Consent Form Completion required for participation in the study: ______________________________________________________________________ [Title of Research Project] INFORMATION ABOUT YOUR INVOLVEMENT IN THIS RESEARCH STUDY You are invited to participate in a research study. The purpose of this study is to seek to understand your personal experience(s) of _________________ _____________________________________________________________________. You, the participant, will have up to two hours within a single interview session to describe your experience(s). Each interview is expected to last between 30 minutes and 2 hours; interview length varies depending on how much time each participant needs to describe his or her experience(s). The interview will be digitally recorded on one or two micro-cassette recorders . The interviewer will transcribe the interview using a word processor . Your name will not be included in the interview transcript or in the final report. A pseudonym will be used instead. The names of cities or people you may mention and other identifying information will also be changed. Audio recordings and transcribed interviews will be stored on a passwordprotected area of the researcher’s computer. They may also be preserved on flash drives and/or compact discs stored in a locked file. Printed transcripts of the interview may also be kept in a locked file. [State how long the data will be stored before being destroyed.] Printed transcripts of the interview will be presented to a research team for analysis and then returned to the primary investigator(s). Each member of the research team involved in this effort shall sign a confidentiality statement . [Explain the extent of confidentiality.] 62 Appendix A Findings, which may include quotes from your interview, will be prepared for publication and presentation at academic conferences. Participation in this study is voluntary. You may decline to participate without penalty. If you decide to participate, you may choose to end the interview at any time without fear of any kind of reprisal. If you withdraw from the study before data collection is complete, your data will be destroyed. Minimal risks are foreseen deriving from your participation in this study. There is no predicted direct benefit to you, individually, for participating in this research. One potential benefit of the research is that it may add to the body of knowledge on this topic. You will not be compensated for your contribution to this study. ______(Initial) Please ask questions about anything you do not understand before deciding whether or not to participate in this research. CONTACT INFORMATION If you have any questions at any time about the study or its procedures, you may contact the researcher [Name] at [Office Address] and [Office Phone Number]. If you have questions about your rights as a participant, contact the Office of Research Compliance Officer at [Phone Number]. ——————————————————————————————————————— ——————————————————————————————————————— CONSENT I have read the above information and I have received a copy of this form. I agree to participate in this study. Participant’s signature ________________________________________________ Date _____________________ ...

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