how do adolescents define depression? - cIRcle - University of ...

APPENDIX A: Parental or Guardian Consent
Appendices
PARENT/GUARDIAN CONSENT FORM: Adolescents' Understanding of Depression and
Help-Seeking Behaviors
Principal Investigator:
Kimberly Schonert-Reichl, Ph.D
Associate Professor
Department of Educational and Counselling
Psychology and Special Education
Phone number: 604-822-2215
Fax: 604-822-3302
E-mail: kimberly.schonert-reichl@ubc.ca
Co-Investigator:
Czesia Fuks Geddes, R.N., MSW,
Ph.D Candidate
Interdisciplinary Studies
Institute of Health Promotion Research
Phone number: 604-822-0634
Fax: 604-822-9210
E-mail: czesia@interchange.ubc.ca
PLEASE COMPLETE THIS PAGE FOR YOUR RECORDS AND RETURN THE
FORM ON THE FOLLOWING PAGE TO SCHOOL WITH YOUR CHILD.
THANK YOU KINDLY.
For further information:
If you would like more information before giving your permission for your son/daughter to
participate in this study or if you have any questions, you may contact the co-investigator at the
Institute of Health Promotion Research, Czesia Fuks Geddes, 604-822-0634, or her research
advisor and Principal Investigator at the Faculty of Educational and Counselling Psychology,
and Special Education, Dr. Kimberly Schonert-Reichl, 604-822-2215. You may also contact
your child's Grade Counsellor.
If you have any concerns about the treatment or rights of your child as a research participant,
you may contact the Director of Research Services at the University of British Columbia, Dr.
Sauder, at (604) 822-8581.
PARENT/GUARDIAN CONSENT:
I have read and understood the details outlined in this letter regarding the study entitled,
Adolescents' Understanding of Depression and Help-Seeking Behaviors.
I understand that my child's participation in this study is entirely voluntary and that I as well as
my child may refuse to participate or withdraw from the study at any time without any
consequence.
I have received a copy of this consent form for my own records.
^ YES, my son/daughter has my permission to participate.
^ NO, my son/daughter does NOT have my permission to participate.
Parent or Guardian's Name:
(please print)
Parent or Guardian's Signature: ^
Son's or Daughter's Name: ^
(please print)
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