The Hong Kong POLYTECHNIC UNIVERSITY
香港理工大學
護理學院
School of Nursing
香港 九龍 紅磡
Hung Hom Kowloon Hong Kong


14 December 2018      

CONSENT TO PARTICIPATE IN RESEARCH

Feasibility and acceptability of an online self-help programme for managing
eating disorders in health clinics


I,  (name)
 

hereby consent to participate in the captioned research which aims to examine the feasibility, acceptability and preliminary efficacy of an online self-help programme "Smart Eating programme" for managing eating disorders in an integrative health clinic at The Hong Kong Polytechnic University and the NHS Tayside Eating Disorders Service in Scotland.

I have read through the information sheet. I understand that information obtained from this research may be used in future research and being published. However, my right to privacy will be retained, i.e., my personal details will not be revealed.

The procedure as set out in the attached information sheet has been fully explained. I understand the benefits and risks involved. My participation in the project is voluntary.

I acknowledge that I have the right to question any part of the procedure and can withdraw at any time without penalty of any kind.

 
Name of participant: :
Name of Parent or Guardian
(under 16 years only):
:
Date :