Administration Centre CFAS
Institute of Public Health
Forvie Site, University of Cambridge
School of Clinical Medicine
Cambridge Biomedical Campus
Cambridge, CB2 0SR
T: 01223 330312
F: 01223 762515
W: www.cfas.ac.uk
CAMBRIDGESHIRE PROJECT FOR HEALTH IN LATER LIFE
CONSENT FORM
Project No: ………………………………….
Please Initial
I confirm that I have read and understood the information sheet (version 3 dated
19/02/2015) for the above study and have had the opportunity to ask questions.
I understand that my participation is voluntary and that I am free to withdraw at
any time, without giving any reason, without my medical care or legal rights being
affected
I agree to take part in the above study.
I understand that this interview is to be taped for training and quality control
purposes. I agree to this interview being audio recorded.
All the information collected by the study is completely confidential and is stored anonymously,
without personal details. Audio tapes are anonymised and used for training and quality control
purposes only and will be destroyed when no longer required.
Name of Respondent………………………………………….
Signature of Respondent……………………………………..
Date………………………………..
Name of Interviewer………………………………………….
Signature of Interviewer………………………………………
Date………………………………..
A Collaborating Centre in the Cognitive Function & Ageing Study
Consent Form: Version 2: 19/02/2015