Please read the Participant Information and Consent Form before completing the questions below.
Declaration by Participant
- I have read the Participant Information Sheet, or someone has read it to me in a language that I understand.
- I understand the purposes, procedures and risks of the research described in the project.
- I have had an opportunity to ask questions and I am satisfied with the answers I have received.
- I freely agree to participate in this research project as described and understand that I am free to withdraw at any time during the project without affecting my future health care.
- I understand that I can print a copy of this document or can be emailed a copy upon request.
- I understand that, if I decide to discontinue the research project treatment, a member of the research team may request my permission to obtain access to my medical records for collection of follow-up information for the purposes of research and analysis.