Consent to participate in Research study
Title of the study : Effect of a program implementation to reduce cardiovascular disease and back problems
Name of investigator : Mr. X , Department: Medical Surgical
Introduction :
You are being asked to be a part of this research study titled " Effect of a program implementation to reduce cardiovascular disease and back problems ". I request you to read this form carefully and ask any question before you agree to participate.
Purpose of the Study:
The purpose of this study is to assess the effectiveness of this program in reducing cardiovascular disease and back problems.
Description of study procedure :
If you are willing to be a part of this study , you will be asked to do the following procedures:
Risks: There are no reasonable predictable risks but there are chances for unpredictable risks.
Benefits : You will be benefitted by reducing the risk of getting cardiovascular diseases and also any back problem.
Confidentiality:
All the information collected during the study will be kept strictly confidential and any electronic records will be coded and keep password protected. I will not include any information about you in any report while publishing this study.
Right to withdraw
You have all the rights to decide whether to participate in the study. Also you can withdraw from the study at any point of time without disturbing the relationship with the investigator.
Right to ask questions
You will have all rights to clarify your doubts , if any, at any point of time- before , during or after this study. Please feel free to contact me if you have any queries.
Declaration
I have read all the above details carefully and giving my consent to participate as a volunteer in this research study.
Subject's name :
Subject's Signature : Date :
Investigator 's Signature :. Date :
Design a sample consent form that will be used as part of your program implementation to...
Create a comprehensive logic model for a program ro help reduce cardiovascular disease and back problems for 120 employees
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