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    Consent Form

    Uploaded by

    Elaiza Mae Medidas
    This consent form outlines the details of a study on practices of community residents regarding self-medication of antibiotics. It defines informed consent and the purpose of obtaining consent. Participants will be interviewed by data collectors about their experiences with self-medication. There are possible risks of emotional stress but no costs to participants. Benefits include having an opportunity to discuss health issues. Participants can refuse or withdraw at any time without impacting their care. Information will be kept confidential except as required by law. No compensation is provided in case of injury from participating.

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    Attribution Non-Commercial (BY-NC)
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    Consent Form

    Uploaded by

    Elaiza Mae Medidas
    221 views2 pages
    This consent form outlines the details of a study on practices of community residents regarding self-medication of antibiotics. It defines informed consent and the purpose of obtaining consent. Participants will be interviewed by data collectors about their experiences with self-medication. There are possible risks of emotional stress but no costs to participants. Benefits include having an opportunity to discuss health issues. Participants can refuse or withdraw at any time without impacting their care. Information will be kept confidential except as required by law. No compensation is provided in case of injury from participating.

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    This consent form outlines the details of a study on practices of community residents regarding self-medication of antibiotics. It defines informed consent and the purpose of obtaining consent. Participants will be interviewed by data collectors about their experiences with self-medication. There are possible risks of emotional stress but no costs to participants. Benefits include having an opportunity to discuss health issues. Participants can refuse or withdraw at any time without impacting their care. Information will be kept confidential except as required by law. No compensation is provided in case of injury from participating.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    221 views2 pages

    Consent Form

    Uploaded by

    Elaiza Mae Medidas
    This consent form outlines the details of a study on practices of community residents regarding self-medication of antibiotics. It defines informed consent and the purpose of obtaining consent. Participants will be interviewed by data collectors about their experiences with self-medication. There are possible risks of emotional stress but no costs to participants. Benefits include having an opportunity to discuss health issues. Participants can refuse or withdraw at any time without impacting their care. Information will be kept confidential except as required by law. No compensation is provided in case of injury from participating.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
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    CONSENT FORM

    Definition of Consent and Informed Consent I am being asked to participate in a non-interventional study. Non-interventional research is a study of classification that involves getting of data in an attempt to understand phenomena or certain conditions. It is also known as observational research and is contrasted with clinical research study. In order to decide whether or not I should agree to be part of this research study, I should understand enough about its risks and benefits to make a judgment. This process is called informed consent. This consent gives information about the research study which will be discussed with me. Once I understand the study, I will be asked to sign this form if I wish to participate. I will have a copy form my own. Purpose of the Study I understand that Eclevia, Bea Marie E., Llantino, Colette III S., Medidas, Elaiza Mae V., Ramos, Art Christian M., Sanchez, Alexandra Agnes A. and Tinaya, Renz Nicole Ross C. of Pamantasan ng Lungsod ng Maynila are doing a study on the Practices of Community Residentson Self-Medication of Antibiotics. Description of Research Procedure If I take part in this study, a data collector will come and interview me. I will be asked to answer questions related to the purpose of the study. I understand that the procedure will cost me no money. Possible Risks I understand that I might be exposed to some emotional stress resulting from fear of the unknown, fear of eventual repercussions and loss of time. Possible Benefits I understand that participation in this study may provide some benefits to me such as comfort in being able to discuss my situation or problem with a friendly or objective person, increased knowledge about my condition either through opportunity for introspection and selfreflection or through direct interaction with researchers, and satisfaction that information I may provide may help others with similar condition. Right to Refuse and Withdraw I understand that I may refuse to participate in this study or withdraw from the study without any change in the care I receive in the health center where I am enrolled.

    Privacy and Confidentiality of Record I understand that information learned from this study will be kept confidential to the extent permitted by law, except as explained in this paragraph. Information obtained from this study may be published or given to other people doing research, but my name and some personal information will not be mentioned. I understand that in the event of injury resulting from participation in this study, no compensation and no free medical treatment or reimbursed is offered by the party involved in this study. Any questions I have asked about this study have been answered to my satisfaction. If I have any questions later on, or if I believe I have suffered injury as a result of participating in this study, I may call Ms.Tess Abila (091234567) and Ms. Maria Andrea Endeno (0916234567) who is the professors of research. By signing this document, I am saying that I have read, and that I agree that I will participate in this study.

    ____________________ Date

    ________________________ Signature of the Participant

    _____________________ Witness (Signature over printed name)

    ________________________ Witness (Signature over printed name)

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