Document Code: DCAVRKMI-F-ICF

MANUEL S. ENVERGA UNIVERSITY FOUNDATION

Lucena City Document Title: Informed Consent Form
An Autonomous University Page No.: Page 1 of 3
Revision No.: 0
DR. CESAR A. VILLARIBA RESEARCH AND Effectivity Date: August 2017
KNOWLEDGE MANAGEMENT INSTITUTE Prepared by: DCAVRKMI
Reviewed by: QMR
QUALITY FORM Approved by: President

INFORMED CONSENT FORM

TITLE :

Inovative, relentless, and agile management ( iRAM ) Model : A resultant of the effects of
observed organizational culture and core values in the operationalization of Total Quality
Management in Higher Educational Institution

STUDY PROPONENT / PRINCIPAL INVESTIGATOR

Author : Engr. Ramela B. Ramirez

CONFLICT OF INTEREST
Declaration : There are no conflicts of interest to declare in relation to this study.
<<The receiving financial payment from the Sponsor / Funder to cover the cost of conducting
this study.

INTRODUCTION

You are being invited to participate in this study because it sought to determine the effects of
observed organizational culture and core values in the operationalization of Total Quality
Management ( TQM 0 in Private Higher Educational Institution in Quezon Province ( PHEI ).
This consent form provides you with information to help you make an informed choice. Please
read this document carefully. If you have any questions, they should be answered to your
satisfaction before you decide whether to participate in this research study.

STUDY BACKGROUND AND RATIONALE

The study is a social research on Higher Educational Institution. The study is being conducted in
order to develop a management system suited for HEIs and provide an innovative method of
managing the changed landscape of HEIs.

BENEFITS

The study is beneficial to students, parents, teachers, non-teaching staff and executives of HEIs
as it would provide the researchers overview of the extent of the effects organizational culture
and core values in the operationalization of TQM in PHEI thus devising innovative ways of
enhancing service delivery thereby increasing customer satisfaction despite changed
organizational landscape.

ALTERNATIVES TO THIS STUDY

 Document Code: DCAVRKMI-F-ICF
MANUEL S. ENVERGA UNIVERSITY FOUNDATION
Lucena City Document Title: Informed Consent Form
An Autonomous University Page No.: Page 2 of 3
Revision No.: 0
DR. CESAR A. VILLARIBA RESEARCH AND Effectivity Date: August 2017
KNOWLEDGE MANAGEMENT INSTITUTE Prepared by: DCAVRKMI
Reviewed by: QMR
QUALITY FORM Approved by: President

If you choose not to participate please inform the researcher by sending a signed e-copy ( word
format or pdf file ) of this informed consent form to

rpbramirez@gmail.com.
ONE’s PARTICIPATION

The study involved development of resultant management model. Participants are involved in
the conduct of data collection. Participants may choose to leave the study anytime however
should inform the researchers prior.

RISKS

The study participants are not subjected to any risk associated with the study.

PRIVACY AND CONFIDENTIALITY

All information provided by the study participants shall be treated with outmost confidentiality.
The Data Privacy Act shall be applied and potential disclosure of personal identifiers was
mitigated early on in the construction of the questionnaire and other data gathering tools.

GROUP CONFIDENTIALITY

During the focus group session or similar arrangement, privacy of all participants in this study
are maintained and all information discussed by all participants and researchers during the focus
group session shall be treated with outmost confidentiality.

OPEN DATA

I understand that the information I will provide in this study will be used for research purposes.
It will not be used in any manner which would allow identification of my individual responses.
Anonymized research data will be archived at <<OPEN DATA SITE>> in order to make them
available to other researchers in line with current data sharing practices.

CONTACT INFO
If you have further questions or concerns about your participation in this study, or if you suffer
any injury related to the study, please contact :

ENGR. RAMELA B. RAMIREZ 0933–927-6165 rpbramirez@gmail.com

Name Mobile No. email
 Document Code: DCAVRKMI-F-ICF
MANUEL S. ENVERGA UNIVERSITY FOUNDATION
Lucena City Document Title: Informed Consent Form
An Autonomous University Page No.: Page 3 of 3
Revision No.: 0
DR. CESAR A. VILLARIBA RESEARCH AND Effectivity Date: August 2017
KNOWLEDGE MANAGEMENT INSTITUTE Prepared by: DCAVRKMI
Reviewed by: QMR
QUALITY FORM Approved by: President

If you have questions about your rights as a participant or about ethical issues related to this
study, you can talk to someone who is not involved in the study at all. That person is

2/M JOEL M. RAMIREZ 0929-630-4385 joe.ram1276@gmail.com

Name Mobile No. email

SIGNATURES
 I understand that my taking part is voluntary; I can withdraw from the study at any time
and I do not have to give any reasons why I no longer want to take part.
 All of my questions and concerns have been answered.
 I understand the information indicated this informed consent form.
 I understand that my participation in this study includes being <<interviewed, recorded
( audio or video ), <other activities expected>>>.
 Optional ( usually clinical trial ) I allow access to my records and specimens, as
explained in this consent form.
 By signing this form, none of my legal rights have been given up.
 Optional ( usually clinical trial ) : I understand that my doctor or healthcare provider may
be informed or my participation in this study.

Francis John D. Pimentel October 19, 2020

Signature over printed name of Participant / Date
Substitute Decision-Maker

ENGR. RAMELA B. RAMIREZ _____ ________________

Signature over printed name of Person Date
Conducting the Consent Discussion

ONLY IF the participant is unable to read or requiring oral translation, accomplish this sub-
section :
 This form is accurately explained to, and apparently understood by , the
participant/substitute decision-maker , and
 Informed consent was freely given by the participant/ substitute decision maker.

_2/M JOEL M. RAMIREZ ___________________ _________________

Printed Name Date
Of Impartial Witness / Translator