Informed Consent Letter
This is an invitation to take part in research being conducted by (name) under the supervision of (instructor) at the (institution). The main aim of the research is to get the whole impression of how a change in lifestyle such as physical activities, socialization, and healthy dieting reduces the chances of developing and progression of Alzheimer’s disease. In addition to that, it will focus on the insight into the association of Alzheimer disease to the lifestyle of an individual, which promotes the development of the condition. Basically, the proposal seeks to establish the relationship between the development of Alzheimer’s disease and the lifestyle of the patient.
The study involves responding to questionnaires and additional background information where necessary. These questions basically touch on the relationship between lifestyle and Alzheimer’s disease among elderly persons. Answering the questions is expected to take not more than 15 minutes to complete and it is necessary for them to be answered genuinely in order to come up with consequential research.
Participation in the questionnaire is optional; one can answer or withdraw from completing the whole questionnaire. Moreover, your name is not required on the questionnaire; hence the information provided will be lacking individuality. After the completion of the data, your participation will form a huge database, which will be reported as group data. (Insert your name), (insert name of instructor) who are the researcher and the supervisor respectively, will be the only people with access to the data.
The completion and return of the questionnaires are a clear indication of your understanding of the kind of the research and voluntary agreement to take part in the study. You may be faced with the challenge of privacy intrusion and having to respond to some questions which you consider sensitive. You may not have any direct benefits as a result of participating in the study.
The results of the study may be of help to us is establishing the relationship between lifestyle and the Alzheimer disease. You may have the alternative of accepting phone interviews, especially when your schedule may not give room for physical interaction. You will be briefed on any other future alternatives available as the study progress. We will ensure that any information you give will be kept very private within the law. However, the analysts of the study will have controlled view of your information for scientific analysis purposes.
Throughout the study process, your real identity will remain anonymous. You will not bear any cost for being a participant in this study. You will have the opportunity to seek refund for any cost that is related to the study upon tabling proof of the same. We will not guarantee a compensation plan for any study related injuries. However, we will provide the necessary treatment when such cases arise. Nevertheless, the sponsors are not liable to provide other compensations besides injuries. Whenever you identify any concern or questions, we encourage you to contact (insert name) at (insert your telephone numbers). We can also be reached at the email address (insert email addresses and any other relevant way of contact). Kindly be informed that you are not relinquishing your legal rights upon signing this document confirming your informed consent and commitment to the study.
Signature of Participant_______________________
Signature of Investigator______________________