Sample Consent Forms Individual Interviews Of Persons With Intellectual Disabilities printable pdf download

Sample Consent Forms Individual Interviews Of Persons With Intellectual Disabilities

Sample Consent Forms

Individual Interviews of Persons With Intellectual Disabilities

Thank you for agreeing to meet with ______________________ and ______________________

(staff) from ______________________ (agency). We will ask questions about making services

better for crime victims with disabilities in ______________________ (city, state). Please read

and, if you agree, sign this form below.

1. ______________________ (agency) will make reasonable accommodations to allow me to

participate in this interview if I ask.

2. What we talk about today will be used by ______________________ (agency) to help make

its services better for persons with disabilities who are hurt by other people.

3. Someone will take notes during the interview. The notes will not include my name or say

who I am. What I say will not be shared with other people outside of this project.

4. I do not have to answer any question I do not want to.

5. If I want to leave, I can. I do not have to say why I want to leave. I can ask for help from staff

in arranging transportation.

6. This interview is not for counseling. If I want to talk after the interview, someone can meet

with me. I can also call ______________________ if I need help after the interview.

Sample Consent Forms Individual Interviews Of Persons With Intellectual Disabilities