research consent form

We very much look forward to hearing your views and experiences. 

In order to ensure that your participation is both informed and freely given, the form at the bottom of this page need to be completed.

Please do read the following first, and also ensure that you have read our terms and policies page too.

Purpose of the research

This study aims to:

* use your insights and experience to improve health and social care

* find out how you identify and describe your health issues and symptoms

* explore any issues you may be having in communicating them to your GP.

* explore how services can be fully accessible, so that no one is left out, left behind or left untreated

How your participation will help:

Your participation in this study will help us make sure that the services we develop will:

* uncover and help support ‘hidden’ disability, health and care needs that are currently unrecognised and unmet

* enable everyone to be understood, and heard, and to get the medical attention and care they need

* take everyone’s health and care needs, experiences and conditions into account

* help health and social care be preventative and work better for everyone, now and in the future.

Why do we need this form?

The purpose of this form is to make sure that you understand what we will be asking you and why, and that you are participating with full and informed consent. This includes:

* how we will manage you the information that you give us

* how it will be stored and used

* what is expected of you and how you would like to participate

* your rights and our responsibilities.

Your privacy and rights

Your participation in this research is voluntary and in confidence.

Any information that you give about your health or symptoms in your responses will also be treated in the strictest of confidence. Please do not discuss the health or experiences of anyone but yourself, and especially not of children or other vulnerable adults.

Information we want to collect

We will ask you a series of simple questions. We will audio record your replies, comments and experiences and type them up without your personal details attached. These ensures that your responses are stored and shared anonymously. How we ensure your privacy. We will publish research reports and presentations that include your comments and actions but your data will be anonymous. This means your name and identity will not be linked in our research reports to anything you say or do.

People in our team may and other people involved in the design of the service may listen to the recording of your session in the future. These recordings will be treated as confidential and will not be shared outside our company.

If you want to withdraw your consent in the future, please contact the person named below by email who will destroy any personal data we hold about you (such your contact details or the recordings). Otherwise, we will delete your personal data after two years.

Lucy Wills

Full data and privacy policies may be found here:

Please sign this form using the checkbox options below to confirm that you consent to participating in this study. We also need your address and contact details so we can identify you and keep in touch.