7.2 Appendix 2: Participant Consent Form
| Researcher: |
Rhonda Wiebe (Manitoba League of Persons with Disabilities) 105 - 500 Portage Ave., Wpg., MB. R3C 3X1 Phone 943-6099 |
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| I understand that: | ||
| my participation in this survey or discussion group is completely voluntary and no form of payment will be given to participants; | ||
| I am able to withdraw from the survey or discussion group at any time; | ||
| I can refrain from answering any questions; | ||
| my name and any information which could specifically identify me will be kept confidential; | ||
| I can withdraw any information I have contributed to this project until such time as the findings are published; | ||
| the research results will not be automatically available to participants unless they are requested. | ||
| I request the results of this research. My address is: | ||
| __________________________________________ | ||
| __________________________________________ | ||
| __________________________________________ | ||
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__________________________________________ Participant Signature |
______________________ Date |
The Will To Live Template Project - Contents
 | Please contact us if you have any questions, comments, or would like to become a member. |
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105-500 Portage Avenue, Winnipeg, Manitoba, Canada R3C 3X1
Telephone: 204.943.6099 (Voice/TTY) Fax: 204.943.6654 Toll Free: 888.330.1932 (Manitoba Only)
Copyright © 1998 - 2012 Manitoba League of Persons with Disabilities Inc.
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