Sample Informed Consent Form For Qualitative Studies (Page 7 of 8) in pdf

 Example of question to elucidate understanding: Do you know that you do not

have to take part in this study if you do not wish to? You can say No if you wish to?

Do you know that you can ask me questions later, if you wish to? Do you know that

I have given the contact details of the person who can give you more information

about the study? Etc.

You can ask me any more questions about any part of the research study, if you wish to. Do

you have any questions?

Part II: Certificate of Consent

This section must be written in the first person. It should include a few brief statements about

the research and be followed by a statement similar the one in bold below. If the participant is

illiterate but gives oral consent, a witness must sign. A researcher or the person going over the

informed consent must sign each consent. Because the certificate is an integral part of the

informed consent and not a stand-alone document, the layout or design of the form should

reflect this. The certificate of consent should avoid statements that have "I understand…."

phrases. The understanding should perhaps be better tested through targeted questions during

the reading of the information sheet (some examples of questions are given above), or through

the questions being asked at the end of the reading of the information sheet, if the potential

participant is reading the information sheet him/herself.

Example: I have been invited to participate in research about malaria and local health practices.

(This section is mandatory)

I have read the foregoing information, or it has been read to me. I have had the opportunity to ask

questions about it and any questions I have been asked have been answered to my satisfaction. I

consent voluntarily to be a participant in this study

Print Name of Participant__________________

Signature of Participant ___________________

Date ___________________________

Day/month/year

If illiterate

I have witnessed the accurate reading of the consent form to the potential participant, and the

individual has had the opportunity to ask questions. I confirm that the individual has given

consent freely.

Print name of witness____________

Thumb print of participant

Signature of witness _____________

Date ________________________

Day/month/year

Statement by the researcher/person taking consent

I have accurately read out the information sheet to the potential participant, and to

the best of my ability made sure that the participant understands that the following will

be done:

A literate witness must sign (if possible, this person should be selected by the participant and should have no connection

to the research team). Participants who are illiterate should include their thumb print as well.

Page 7 of 8

Sample Informed Consent Form For Qualitative Studies Page 7