Informed consent: ‘Diabetes and alcohol’ survey

Edinburgh Napier University requires that all persons who participate in research studies give their written consent to do so. Please read the following and sign it if you agree with what it says.

  1. I freely and voluntarily consent to be a participant in this research to be conducted by
    • Dr Bruce Ryan and Dr Gemma Webster, staff members in the Edinburgh Napier University School of Computing
    • Dr Abdelfateh Kerrouch, staff member in the Edinburgh Napier University School of Engineering and the built environment.
    • Jacqui Charlton, staff member in the Edinburgh Napier University School of Health and Social Care, and staff member in NHS Lothian
    • Alicja Szewczyk, staff member in NHS Lothian.
  1. I have been informed of the broad goal of this research. I have been told what is expected of me and that the survey should take no longer than 15 minutes to complete.
  2. I have been told that my responses will be anonymised. My name will not be linked with the research materials, and I will not be identified or identifiable in any report subsequently produced by the researcher. I have been told that these data are may be submitted for publication.
  3. I also understand that if at any time during the survey, if I feel unable or unwilling to continue, I am free to leave. That is, my participation in this research is completely voluntary, and I may withdraw from it at any time without negative consequences.
  4. In addition, should I not wish to answer any particular question or questions, I am free to decline.
  5. I have been given the opportunity to ask questions regarding the survey and the research, and my questions have been answered to my satisfaction.
  6. I have read and understand the above and consent to participate in this study. My signature is not a waiver of any legal rights. Furthermore, I understand that I will be able to keep a copy of this consent form for my records.

Participant’s Signature                                   Date



I have explained and defined in detail the research procedure in which the respondent has consented to participate. Furthermore, I will retain one copy of the informed consent form for my records.


Researcher’s Signature                        Date