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

Project title: Research into how PHARMAC’s ‘Community 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 audio-taped 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):
Please sign both copies of this form and retain one copy for your records and
Yes or No
Please return the other copy of this form in the stamped addressed envelope provided. Thank you.
Participant - Signature:..................………………………………………….
Participant - Name: .....................................................……………………
Participant - Email ……………………………………………….……………………….
Date: …………………………………………………
Approved by the Auckland University of Technology Ethics Committee Ethics Application Number
07/196
270