Consent to participate in research

Please download and retain a copy of this Consent Form for your own records. Consent Form (right click and save as…)

Please complete this page only after you have read the Information Sheet carefully.

I have read, understood and kept a copy of the Research Project Information Sheet for the above research project.  Any questions I have had have been answered to my satisfaction, and I understand that I may ask further questions at any time.

I realise that this research project will be carried out as described in the BetterBonds Information Sheet.

I have had time to consider whether to take part and to ask a friend or family member for support to understand the study.

I understand that taking part in this study is voluntary (my choice) and that I may withdraw from the study at any time and this will in no way affect my future health care.

I give permission for anonymised results of the measures I will complete to be used in this research project.

I understand that once the measures are completed there will not be the opportunity to make changes as they are anonymous.

I am over the age of 18 years.

I understand that my participation in this study is confidential and that no material, which could identify me, will be used in any reports on this study.

I give consent for data to be used in a confidential manner as described in the BetterBonds Information Sheet.

As part of logging on to the BetterBonds intervention, I understand I will need to enter my email and that this may be retained. My email address will not be linked to my responses on this website.

I consent to my email address being retained. I understand I may be contacted in the future for a longer-term follow up.

I understand that the intervention should be stopped if it appears to be harmful to myself or others.

For the research purposes, the traffic to this website will be collected and analysed. This is done solely by tracking website activity from our web server and in no way, can users be identified.

I have read the terms and conditions of entry to the prize draw for an iPad and understand my email will be retained for the purposes of the prize draw.

Any questions I have about this research project and my participation in it have been answered to my satisfaction.

I know who to contact if I have any side effects from the intervention (See the contacts page).

I know who to contact if I have any questions about the study (See contacts page) https://impotenzastop.it/.

I agree to participate in the study under the conditions set out in the Information Sheet.

Thank you for your kind consideration.

Consent Form                         Version 2.0                       Date 10.07.2018