VELEZ COLLEGE
                 F. Ramos Street, Cebu City, Philippines
This Informed Consent Form is for men and women who belong in the generation of Baby Boomers,
those born from 1946 to 1964, and who we are inviting to participate in the research on the awareness
affecting the varied attitudes towards Telemedicine. The title of our research study is “The Relationship
between Awareness and Attitude towards Telemedicine among Baby Boomers in Barangay Guadalupe,
Cebu City”.

Gotico, Angela Margarette Tricia D. 

Alinsug, Gian A.
Arriesgado, Myangel Loise V. 
Lim, Yanna Moriah R.
Padillo, Christine Nina B.

This Informed Consent Form has two parts:

 Information Sheet (to share information about the research with you)
 Certificate of Consent (for signatures if you agree to take part)

You will be given a copy of the full Informed Consent Form

PART I: Information Sheet

Introduction
We are the members of Group 3 of BSN-3C Nursing Research class of Velez College, Inc. We are doing a
research on the awareness that affects the attitudes towards Telemedicine among baby boomers in Cebu
City. We are going to give you information and invite you to be part of this research. You do not have to
decide today whether or not you will participate in the research. Before you decide, you can talk to
anyone you feel comfortable with about the research. 
There may be some words that you do not understand. If you have questions, you can ask us, the
researchers.
Purpose of the research
Because of the Covid-19 pandemic, our lives have been greatly affected. The status of those infected,
hospitalized, and died due to the COVID-19 virus has been on the rise. A large sum of hospitals in the
Philippines are at full capacity. Because going to the hospital carries a risk of getting the virus, staying at
home is safer. The age group most affected by the pandemic are the older people. They are at the highest
risk of getting the Covid-19 virus, especially if they are exposed in public settings such as the hospital.
Telemedicine is a convenient method of care for older people to receive health care from physicians in the
comfort of their homes. In the Philippine context, different telemedicine services are offered such as
MedGate, KonsultaMD, and others. However, a low status of utilization towards telemedicine a variety of
attitudes towards this innovation is evident in the local setting. The reason we are doing this research is to
find out whether awareness influences the attitude of older people, specifically the baby boomers, towards
Telemedicine.
Type of Research Intervention
This research will involve a self-administered, close-ended questionnaire, wherein participants will fill
out the questionnaire without the researchers' intervention.  
Affiliation/Sponsorship
The study is an academic requirement to fulfill the subject Nursing Research 1 & 2 of Velez College –
College of Nursing. The process of making the group’s research is guided by their Research Adviser, Ms.
Jacqueline Therese P. Sanchez, RN, MN. Sponsorships and funding of the study are funded by the
researchers themselves.
Participant selection
We are inviting the baby boomers in Barangay Guadalupe, aged 57 to 75 years old, with or without
telemedicine awareness and experience, to participate in the study. The study excludes chronically ill
baby boomers and those diagnosed with cognitive impairment such as Alzheimer's disease, paralysis or
stroke, Parkinson's disease, multiple sclerosis, and traumatic brain injuries. The baby boomers were
selected to be the respondents since: they are the number one health consumers, the age group more
susceptible to diseases thus increasing healthcare demand, and the age group least likely to engage with
telemedicine. The baby boomers in Barangay Guadalupe were chosen for the study since they have the
highest population of the said age group in Cebu City of about 5, 858 baby boomers. 

Voluntary Participation
Since your participation in this study is entirely voluntary, it is your decision whether or not to participate.
Even if you consented earlier, you still have the right to change your mind and discontinue participating
at any time. Discontinuing from this study will not affect the relationship you have, if any, with the
researcher. Furthermore, all data that you will provide will be used for research purposes only and will
only stay among the researchers and relevant department, the College of Nursing, which is involved in
carrying out the study. 
Procedures and Protocol
Description of the Process
 Upon the distribution of the online questionnaires, clear instructions will be stipulated in the
cover letter of the questionnaire together with the informed consent.
 The participants will then be informed that their participation is entirely voluntary, and they have
the right to refuse and withdraw at any time. The researchers will also emphasize that answering
the said survey questionnaire will directly imply the participant’s consent to participate in the
study. If they wish not to participate, they may discard the form sent. The participants will also be
reminded that failure to volunteer will not result in any penalty or loss of benefits.
 Upon the data collection process, the researchers will utilize Google Forms in conducting the
survey which will be sent to the participants through e-mail (Gmail or Yahoo) or Facebook
Messenger, depending on the participant’s preference.
 During the actual data gathering process, the process of accomplishing the survey questionnaire
will take approximately 10 minutes of the participant’s time.
 Upon carrying out the data collection process, the researchers will remind the participants that
they will be available for any untoward questions and concerns when filling out the questionnaire
 and they may directly contact the researchers via mobile phone, e-mail, or FB messenger and the
researchers will try to address their questions and concerns as soon as possible.
 The participants may also ask for assistance from any of their significant others or family
members. 
 The researchers will provide time to the participants to answer the online questionnaire and
submit it after they are done. 
 Afterward, the participants will be given a money incentive of Php 50.00 via GCash or other
payment method as a token and appreciation of their involvement in the study.
 All research data encoded on the computer shall be password-protected in a Google Drive folder
under the same email address which can only be accessed by the researchers. No other personnel
will have access to the folder. Data will be then organized, validated, and interpreted once the
researchers collected all the responses approximately 2-4 weeks. All documents kept in the folder
shall be deleted from Google Drive upon completion of the study, and all printed copies of the
documents used in the study shall be shredded and discarded approximately 3-5 years from the
completion of the research study.
 When the study is completed, the participants can contact the researchers if they wish to know the
study results regarding the relationship between awareness and attitude towards telemedicine
among baby boomers in Barangay Guadalupe, Cebu City. The researchers will send it to the
participants through e-mail or FB messenger.

Duration 
The researchers will perform the following order during the actual data gathering: to introduce the
group’s study and survey questionnaire, xto ask regarding the Informed Consent whether you consent
through signing the form, and to collect the survey if you agree to participate in the study. The researchers
only need 5 minutes to introduce the group’s research, informed consent, and survey questionnaire to you
while the survey only takes you about 10 minutes to answer the questions. The questionnaires will be
collected through Google forms, in which the answers and data will automatically be collected once the
submit button is clicked. However, if you have any questions or clarifications, you may message the
research members. Once you complete the questionnaire, there will be no more follow-up surveys or
meetings. 

Risks
By participating in this research, there is a chance you may find some questions personal, e.g., awareness,
attitude. You may feel uncomfortable answering some of the questions or topics. You may find some
statements against your beliefs. If any of these risks happen to you, you have the right to stop
participating in the study. If you believe specific questions request unnecessary personal information, you
may withdraw from the study.
Benefits 
If you participate in this research, there may not be any immediate benefit for you but your participation
is likely to help us find the answer to our research question, which is identifying the relationship between
different factors to the attitudes toward telemedicine of baby boomers residing in Barangay Guadalupe.
There may not be any benefit to society at this stage of the research, but the knowledge that will be gained
through this research will be useful in helping us understand the varied attitudes towards telemedicine and
what can be done in order for baby boomers to gain acceptance regarding the use of telemedicine. 
Reimbursement/Compensation
Since the study does not involve experimental and clinical process that might cause potential harm to the
participants, no reimbursement is to be given to the participants.
Confidentiality
Within the confines of this research, there is a possibility that if others are aware of you participating in
this research, they might be curious to ask questions to the researchers. So regarding this matter, the
researchers will not be sharing the identity of its participants
We, as the researcher will make certain that the information collected from this research paper shall be
kept confidential. Any information about the participants shall be stored and only the researchers will be
able access or see the information. The information about you will be converted to a Number/Initials to
conceal your real names and will be stored privately. Information will not be shared to anyone except the
researchers.
Sharing the Results
The hard copy of this research will be stored in the library of Velez College. The students and instructors
of the college will have access to the study. Rest assured that confidential information will not be shared
in the study. Also, once the research study is complete, it will be published online in a research-related
online sites, where the participants or people interested in the topic will be able to have access to the
results of this research study through typing the research’s title and keywords in the search bar. Lastly, the
participants can also be given a soft copy of the completed study in their emails if they requested to know
the study’s result.
Right to Refuse or Withdraw
This is a reminder for the participants that you do not have to take part in this research if you do not wish
to do so. As participants of this research study, you have the right to withdraw at any point in time and
you also have the right to withhold any information you gain from the study. The researchers will respect
any decision you make.
Who to Contact
This proposal has been reviewed and approved by the Velez College Ethics Review Committee, which is
a committee who is responsible in making sure that research participants are protected from harm.  If you
wish to find out more about the VCERC or questions or concerns regarding this study, please contact
Mrs. Kachiri T. Salibio-Mercadal through telephone number (032)253-1871 loc 901 or by email at
velezerc@gmail.com. Their office is also located at 41 F. Ramos Street, Cebu City 6000.
If you have any concerns and explanations, don’t hesitate to ask. You can contact anyone of the
following:

 Angela Margarette Tricia Gotico (Primary Investigator) - 09455209886

 Gian Alinsug - 09177137799
 Myangel Loise Arriesgado - 09064035319
 Yanna Moriah Lim - 09208064359
 Christine Nina Padillo - 09456613422 

PART II: CERTIFICATE OF AUTHORIZATION 

I have read and comprehended the provided information. I have had the opportunity to raise my concerns
and clarifications about the study which have been answered to my satisfaction. I have been briefed
regarding my right to refuse and withdraw from the study. I have been given the list of contact people to
contact regarding any additional information I wanted to know. I consent voluntarily to participate as a
participant in this research.

Print Name of Participant__Adelpha A. Busano____

Signature of Participant ______________________
Date ___May 19, 2022______
Day/month/year
Print Name of Impartial Witness__Robert P. Anlocotan Jr.__
Signature of Impartial Witness_________________
Date ___May 19, 2022______
Day/month/year
Statement by the researcher/person taking consent

I have comprehensively and accurately recited the information sheet to the potential participant, and to
the best of my ability made sure that the participant fully understands that the following will be done:

1. Answer comprehensively the data needed to be filled in from the survey questionnaire

2. Maintain honesty from the provided answers

I confirm that the participant was given an opportunity to raise his/her concerns and clarifications about
the study, and all the questions have been answered correctly and to the best of my ability. I confirm that
the individual has not been forced into giving consent, and the consent has been given freely and
voluntarily.  

 A copy of this ICF has been provided to the participant.

Print Name of Researcher/person taking the consent ___Myangel Loise V. Arriesgado___

Signature of Researcher /person taking the consent __________________________

Date ___May 19, 2022______
                 Day/month/year