Consent Form

Purpose:
This study investigates the people’s opinions on EATING HEALTHY HABITTS. As part of this
study you will be asked to participate in a focus group and answer structured and open-ended
questions. This study will take approximately 60 minutes.
Participants’ Rights and Obligations:
 Participant responses will be kept in the strictest of confidence and would be used for
research purpose only.
 No one will be able to identify participant when the results are reported and analyzed.
participant name will not appear anywhere in the transcribed document.
 Participant will maintain anonymity of other participant in the group and will not share
other people identify present in the group.
 Participant can skip any specific question they don’t wish to answer but they would
ensure that they participant actively in the session so that objectives of study could be
achieved.
 Participant agree to audio tape the whole discussion so that it would be used as a source
to transcribe for further study.
 Participant agree to video take the discussion as required by the observer.
 Participant agree to also allow observers to include nonverbal language in their research
work.

Consent to Participate
I acknowledge that I am at least twenty years old, and that I understand my rights as a focus
group participant as outlined above. I acknowledge that my participation is fully voluntary and
will abide by the rules of discussion.

Signature: ______________________________________ Date: _____________