Appendix G: Example of Informed Consent—Student Thesis

Massage Therapy Patients’ or Clients’ Compliance With Treatment From the Therapists’ Perspective

__________________ (Hereafter known as the “Investigator”) has asked ____________________ (Hereafter known as the “Participant Therapist”) to take part in a study regarding massage therapy patients and their compliance with treatment.

The Participant Therapist will be asked to tell the Investigator two stories, one about a patient or client the Participant Therapist perceived as successful and one about a patient or client the Participant Therapist perceived as unsuccessful. He or she will also be asked to discuss what elements he or she thinks make a patient or client successful or unsuccessful. The Investigator will audiotape the stories and all questions and answers.

Participation in the study is voluntary and the Participant Therapist has the right to discontinue participation at any time without repercussions. There are no discomforts or risks associated with the study.

Information from the study will be coded to ensure confidentiality, and the Participant Therapist will not be identified in any publication that may result from the study. The audiotapes will be heard by the Investigator, a transcriber, and possibly by another occupational therapy student (who will aid in selecting relevant portions of the tape for transcribing), and the three faculty advisers to the investigator.

The transcribed stories will not be printed for public use, but short excerpts will be taken from them and included in the Investigator’s thesis and in possible future publications.

The Investigator will be available to answer further questions regarding any aspect of the study or participation therein _____________/________________ (phone/e-mail).

I understand that members of the Human Subjects Committee of the ______________________are also available to answer questions and their names, phone numbers, and e-mails are as follows:

I agree to participate in the study described above. I have been given a copy of this form.

Signed:

__________________ Date:___________________

Participant Therapist

__________________ Date:___________________

Investigator

__________________ Date:___________________

Witness