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Consent Agreement for Audio or Video Recording

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Consent Agreement for Audio or Video Recording Powered By Docstoc
					           Privacy act Statement and Consent Agreement
                   for Audio or Video Recording
                     (to be attached to the written informed consent)

I have received a thorough description of the purpose and procedures for [specify audio
or video] recording during the course of the proposed research study. I give my consent
to allow recording during participation in this study, and for those records to be reviewed
by persons involved in the study, as well as (describe any other professional purposes that
they may be used for). I understand that all information will be kept confidential and will
be reported in an anonymous fashion, and that the recordings will be erased [specify
time] after the study has been completed. I further understand that I may withdraw this
consent at any time without penalty.


________________________________________                    __________________
Participant’s Signature                                     Date

________________________________________                    __________________
Researcher’s Signature                                      Date

				
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posted:2/15/2011
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Jun Wang Jun Wang Dr
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