GriefNet Research Information

 

INFORMED CONSENT FORM
(used by Dr. Lynn for her dissertation)

 

The research project to be conducted by Cendra Lynn of The University of Michigan's School of Education as part of her dissertation has been explained to me. I understand that my participation is completely voluntary.

I understand that if I agree to participate I will be asked to fill out a short questionnaire and to participate in two inter-views with Cendra Lynn. The first interview will be the longer, about two hours. The second will occur several weeks after the first and will be shorter, approximately one hour long. I under-stand that these interviews will be tape recorded and that some written notes will also be taken.

I realize that I will be asked to talk about my personal grief and bereavement and I understand that this may, at times, be up-setting. Also I understand that the opportunity to talk at length about grief is some times found to be helpful to bereaved persons.

I understand that Cendra Lynn will answer any questions I have about my participation in this study and that I will be offered a copy of her completed dissertation. I understand that all information I give will be kept confidential and that my identity will not be revealed. Cendra Lynn has explained her procedures for keeping my confidentiality and identity private and I understand she will discuss freely any further concerns I have about this.

I understand that I am free to withdraw my consent and to discontinue my participation in this project at any time and that such withdrawal would not be held against me in any way.

On the basis of the above statements I agree to participate in this project.

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Participant's signature

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Investigator's signature

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Date

Cendra Lynn
Ann Arbor, MI