CONSENT FORM FOR OBSERVATION DURING FORMAL AND INFORMAL MEETINGS
1. Information on the research project
You have been invited to participate in the following research project:
SPECIFY THE TITLE OF YOUR RESEARCH PROJECT HERE (REMEMBER TO REMOVE ALL INSTRUCTIONS IN GREY BEFORE SUBMITTING THE DOCUMENT TO THE REB.)
This project is being conducted by:
YOUR STATUS (EX. PROFESSOR, MASTER’S OR PH.D. STUDENT) YOUR NAME, YOUR EMAIL ADDRESS, YOUR TELEPHONE NUMBER
SUPERVISOR, CO-SUPERVISORS, CO-INVESTIGATORS, THEIR NAMES, EMAIL ADDRESSES, TELEPHONENOs.:
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Master’s OR Ph.D. student, HEC Montréal:
YOUR NAME
Tel.: 000-000-0000
Email:
Supervisor:
NAME
Tel.: 000-000-0000
Email:
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Summary:PROVIDE A BRIEF SUMMARY OF YOUR RESEARCH PROJECT, USING LANGUAGE THAT RESPONDENTS CAN EASILY UNDERSTAND (AVOID JARGON). MAXIMUM OF 5 LINES.
2. Research ethics considerations
Your organization has agreed to participate in this research project. The researcher is requesting your authorization to observe formal and informal meetings.
HEC Montréal’s Research Ethics Board has determined that the data collection related to this project meets the ethics standards for research involving humans. If you have any questions related to ethics, please contact the REBsecretariat at (514) 340-6051 or by email at . Do not hesitate to ask the researcher any questions you might have.
3.Confidentiality of personal information gathered
You should feel free to answer the questions frankly. The researcher, as well as all other members of the research team, if applicable, undertake to protect the personal information obtained by ensuring the protection and security of the data gathered from participants, by keepingall recordings in a secure location, by discussing the confidential information obtained from participants only with the members of the research team and by refraining from using in any manner data or information that a participant has explicitly requested be excluded from the research.
Furthermore, the researchers undertake not to use the data gathered during this project for any purpose other than that intended, unless approved by HEC Montréal’s Research Ethics Board. Please note that by consenting to participate in this research project, you also consent that the data gathered may be used for future research projects, subject to approval of any such projects by HEC Montréal’s Research Ethics Board.
All persons who may have access to the content of your interview, as well as the person in charge of transcribing the interview, have signed a confidentiality agreement.
4.Authorization to participate as an observer (non-participant) and protection of personal information in the publication of research results
The information that you provide will be used to produce a document that will be made public. It is up to you to indicate the level of protection of your personal information that you would like with regard to the publication of the research results. IT IS NOT ESSENTIAL TO OFFER A CHOICE; A SINGLE OPTION MAY SUFFICE.As such, you must indicate to us whether or not you consent to be the subject of observation as part of this research project. The observation will be conducted during formal or informal meetings.
KEEP ONLY THOSE OPTIONS THAT YOU PLAN TO ACTUALLY USE. MOREOVER, THE OPTIONS SHOULD REFLECT YOUR SPECIFIC SITUATION. FOR EXAMPLE, INDICATE WHETHER YOU INTEND TO MENTION THE NAME OF THE ORGANIZATION, OR WHETHER YOU INTEND TO REFER TO THE RESPONDENTS AS MANAGERS, EMPLOYEES OR OTHERWISE IN THE RESEARCH RESULTS. THIS SHOULD ALSO BE SPECIFIED TO THE RESPONDENT.
Option 1:
I consent to being the subject of observation by the researcher and to my title only being mentioned in the publication of the research results. Under no circumstances may my name be disclosed.
If you check this box, only your title will be disclosed in the dissemination of the research results and you are giving your consent to be observed by the researcher. It will also be mentioned that this research project is being conducted at IDENTIFY THE ORGANIZATION.It is therefore possible that a party inside or outside the project team could obtain your name by cross-referencing. Consequently, complete protection of your anonymity cannot be assured.
Option 2:
I consent to being the subject of observation by the researcher, but I do not wish either my name or my title to be mentioned in the publication of the research results.
If you check this box, you are giving your consent to be observed by the researcher, but no information concerning either your name or your title will be disclosed in the dissemination of the research results. However, it will also be mentioned that this research project is being conducted at IDENTIFY THE ORGANIZATION.It is therefore possible that a party inside or outside the project team could obtain your name by cross-referencing. Consequently, complete protection of your anonymity cannot be assured.
Option 3:
I refuse to be the subject of observation by the researcher.
In this case, all information concerning you will be omitted from the dissemination of the research results.
SIGNATURE OF THE PARTICIPANT IN THE MEETING:
First and last name: ______
Signature: ______Date (dd/mm/yyyy): ______
RESEARCHER’S SIGNATURE:
First and last name: ______
Signature: ______Date (dd/mm/yyyy): ______
ASIGNED COPY OF THIS FORM MUST BE GIVEN TO EACH PARTICIPANT.
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