How does the operation of PHARMAC's 'Community Exceptional ...

Appendix 3: Key Informant Consent Form
Project title: Research into how PHARMAC’s ‘exceptional circumstances’ policy is applied.
Project Supervisor: Professor Marilyn Waring
Researcher: Greg Coyle
I have read and understood the information provided about this research project in the
Information Sheet dated 2nd September 2007.
I have had an opportunity to ask questions and to have them answered.
I understand that notes will be taken during the interviews and that they will also be audiotaped
and transcribed.
I understand that I may withdraw myself or any information that I have provided for this project
at any time prior to completion of data collection, without being disadvantaged in any way.
If I withdraw, I understand that all relevant information including tapes and transcripts, or parts
thereof, will be destroyed.
I agree to take part in this research (please tick one); Yes or No
I wish to receive a copy of the report from the research (please tick one):
Yes or No
Please sign both copies of this form and retain one copy for your records and
Please return the other copy of this form in the stamped addressed envelope provided. Thank
you.
Participant’s signature:..................………………………………………….
Participant’s name: .....................................................……………………
Participant’s Email address ……………………………………………….
Date: ………………………………………………………………………….
Approved by the Auckland University of Technology Ethics Committee Ethics Application Number
07/196
269