Statement of Agreement to Participate in the Research Study:

  • I hereby confirm that I have been informed by the researcher, Mrs J Ducray, about the nature, conduct, benefits and risks of this study – Research Ethics Clearance Number: IREC 043/18.
  • I have also received, read and understood the above written information (Participant Letter of Information) regarding the study.
  • I am aware that the results of the study, including personal details regarding my sex, age, date of birth, initials and diagnosis will be anonymously processed into a study report.
  • In view of the requirements of research, I agree that the data collected during this study can be processed in a computerised system by the researcher.
  • I may, at any stage, without prejudice, withdraw my consent and participation in the study.
  • I have had sufficient opportunity to ask questions and (of my own free will) declare myself prepared to participate in the study.
  • I understand that significant new findings developed during the course of this research which may relate to my participation will be made available to me should I so wish.