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Consent to take part in[] Add your initials next to the statements you agree with I confirm that I have read and understand the information sheet/ letter [delete as applicable]dated[insert date]explaining the above research project and I have had the opportunity to ask questions about the project. Agree I understand that my participation is voluntary and that I am free to withdraw at any time without giving any reason and without there being any negative consequences. In addition, should I not wish to answer any particular question or questions, I am free to decline. Insert contact number here of lead researcher/member of research team (as appropriate). Agree I give permission for members of the research team to have access to my anonymised responses. I understand that my name will not be linked with the research materials, and I will not be identified or identifiable in the report or reports that result from the research. I understand that my responses will be kept strictly confidential[only if true]. Agree I agree for the data collected from me to be used in relevant future research.Agree I agree to take part in the above research project and will inform the lead researcher should my contact details change.Agree Name of participant Participant’s signature Date Name of lead researcher [or person taking consent] Signature Date* *To be signed and dated in the presence of the participant. Once this has been signed by all parties the participant should receive a copy of the signed and dated participant consent form, the letter/ pre-written script/ information sheet and any other written information provided to the participants. A copy of the signed and dated consent form should be kept with the project’s main documents which must be kept in a secure location.