King's Health Behaviour Change

Information Sheet and Consent Form

King’s College Research Ethics Committee Ref: LRS-16/17-4036

Before you consent to take part in this survey, please read this information sheet.

Thank you for considering taking part in this research. The person organising the research must explain the project to you before you agree to take part. If you have any questions arising from the Information Sheet or explanation already given to you, please contact the researcher (julia.haas@kclsu.org) before you decide whether to join in. You can access the Consent Form here to keep and refer to at any time.

Question Title

* 1. Please tick all of the boxes below to participate in this survey.

I confirm that I have read and understood the information sheet dated 17 March 2017 for the above study. I have had the opportunity to consider the information and ask questions, which have been answered satisfactorily.

I understand that my participation is voluntary and that I am free to withdraw at any time without giving any reason. Furthermore, I understand that I will be able to withdraw my data only on the date of submission for the questionnaire (because of the anonymity).

I consent to the processing of my personal information for the purposes explained to me. I understand that such information will be handled in accordance with the terms of UK Data Protection Act 1998.

I understand that my information may be subject to review by responsible individuals from the College for monitoring and audit purposes.

I understand that confidentiality and anonymity will be maintained and it will not be possible to identify me in any publications.

Question Title

* 2. Participant’s Statement: 'I agree that the research project named above has been explained to me to my satisfaction and I agree to take part in the study. I have read both the notes written above and the Information Page about the project, and understand what the research study involves.'

Please tick one box below.

Yes

Investigator’s Statement: I, Julia Haas, confirm that I have carefully explained the nature, demands and any foreseeable risks (where applicable) of the proposed research to the participant.

Signed: Julia Haas, King's College London Students' Union Wellbeing Coordinator

Date: 17 March 2017

20% of survey complete.