By completing and submitting this form, you are agreeing to contribute your data to the research component for my MSc Integrative Psychotherapy dissertation at the Sherwood Psychotherapy Training Institute (SPTI), and for the preparation of the research findings for publication in a peer-reviewed journal (if indicated below).

You are also signing to indicate that (please tick all applicable boxes below):

Your Name:

Telephone number:

Your Email:

you have voluntarily agreed to be a participant in this research.

you have read and understood the accompanying Information Pack, poster, and letter sent with this consent form.

you have had enough time to read and reflect on this information, and you have had the opportunity to ask questions or raise concerns.

you understand all efforts will be made to ensure that confidentiality and your anonymity will be maintained throughout this research project.

you will be sent a copy of the transcript of your interview(s) and you have the opportunity to remove any information you choose not to authorise for inclusion in the research.

for interviews using video conferencing you have read, understood, and are happy with the relevant privacy and security information (https://zoom.us/docs/en-us/privacy-and-security.html)

you give consent for the findings to be used in Justin Clark’s MSc dissertation.

you have the right to withdraw at any time before the 31st December 2020, without reason and without the threat of any adverse effect. All of your data will be removed from the study.

you have the right to withdraw at any time, without reason and without the threat of any adverse effect. If you withdraw after 31st December 2020 your data provided up to the point of withdrawal will not be removed from the study, but any further involvement will cease.

you understand this research project will be seen by two internal markers from SPTI and an external marker, who are all UKCP registered Psychotherapists bound by confidentiality and the ethical frameworks of SPTI and UKCP.

you understand that a copy of the dissertation (subject to meeting the criteria to pass) will be held in the SPTI library, access to which is controlled by strict viewing criteria.

you give consent for your data to be published or presented elsewhere at a later date and that the research will be presented in a format available more widely.

By typing your name here you are agreeing to the above statements as indicated.
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