Informed Consent to Participate in the research titled:

________________________________________

Please read this document carefully so that you can make an informed decision about
participating in this study. An in-depth interview is being conducted as part of the requirements
for thesis writing – a requirement for the degree Bachelor of Science in Psychology at the Rizal
Technological University. The interview will be conducted by ___________________________.
Feel free to ask any questions before signing this document and understand your participation
in is completely voluntary.
The interview: The interview will consist of ______parts. It will ask you
about____________________, _______________, __________and ____________. It may last
between _______ hours and generally takes _______________(ilang sessions ba?). We will
also ask permission to record our interview and take some notes.

Confidentiality:
You will be assigned a code name which will protect your identity. The information obtained in
this interview is confidential, will be kept in secured files and will not be released to any person
or organization without your written permission. Audio and video recordings will also be
immediately discarded after analysis. As part of the process, persons and organizations you
mentioned in the interview will not be identified in the paper.

Opportunities to Withdraw at will:

If you decide now or at any point to withdraw this consent or stop participating, you are free to
do so at no penalty to yourself. You are free to skip specific questions and continue participating
at no penalty.
Informed Consent
By signing this document you are indicating that you have read and understand the information.
You have been given the opportunity to ask questions and agree to the terms described.

___________________________________
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Signature of Participant

Date: ______________________________