INFORMED CONSENT FORM FOR PARTICIPANTS
Name of Investigators : (inyong name tanan)
Name of School :
Study Title :
PART I: INFORMATION SHEET
INTRODUCTION
First paragrapgh sa inyo letter approval
In this regard, we would like to invite you to participate in this research study to answer the survey questions.
During the conduct of the study, it is assured that if you do not understand some words or concepts, these will be
explained and that you can ask anything you do not understand before deciding whether or not to participate. Please
take as much time as you need to read the consent form. You will be asked to sign this form. Should have any
questions concerning the research study, please call us through the mobile phone indicated below.
PURPOSE OF THE RESEARCH
This study seeks to quantitatively assess the (purpose of the study)
TYPE OF RESEARCH INTERVENTION
If you decide to participate in this study, you will be answering series of questions designed to help us
investigate the ( purpose of the study) perceived by you.
PARTICIPANT SELECTION
You have been selected to participate in this study along with other male Senior High School students in the
school. Your insights are crucial in understanding the (purpose of the study and general significance of the study).
VOLUNTARY PARTICIPATION
Your participation is voluntary and no payment beyond reimbursements for expenses incurred as a product of
participation. You have the right to participate or not to participate in this research study. There will be no penalty
or loss of benefits for either decision. If you agree to participate, you stop at any time.
PROCEDURES
The study will employ a self-rating tool on your perception with the (two variables). The data gathered from the
survey questionnaires will be processed and analyzed.
The survey questionnaire will be given to you, and you will be asked to answer the necessary information to the
conduct of this study. This may be done during your free time. The survey shall be retrieved on the following day.
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Any extra precautions will be considered to ensure confidentiality and no one else will have access to the results of
the survey. Therefore, you may not write your name.
DURATION
Your commitment will greatly contribute to the progress of this study. It will take you 5-10 minutes to complete
the questionnaire. This will be done during your time.
RISKS
There is no risk to you in participating in this project as all information about you will be kept strictly confidential.
Likewise, your involvement in the project will not in any way affect your studies and job-related standing.
BENEFITS
This research aims to assess (purpose). General significant of the study to male students and female in their later
life.
REIMBURSEMENTS
Your participation is voluntary and no payment beyond reimbursements for expenses is incurred as a product of
participation. To compensate the participants’ generosity in giving time for data collection, a message of gratitude
will be sent to them.
CONFIDENTIALITY
Confidentiality, privacy, and anonymity will be ensured in the collection, storage, and publication of research
material in the unlikely event that could occur, the data associated with the result will be suppressed or presented
differently so as not to violate privacy. The data generated during the research will be kept securely in electronic
form for one month after the completion of the research. Only the researcher knows as to where and how the data
will be accessed. After a month , the data will be permanently deleted from the file.
SHARING THE RESULTS
No one else except the researcher, research adviser, statistician, and individuals engaged in the data analysis will
have access to the collected data. The finalized paper will be made accessible at the campus librar y of Gingoog
City Comprehensive National High School wherein the findings of the research will be shared for future studies.
The university’s approval as well as your consent will be taken into consideration before publication. In the event
the study results are published, your identity as a participant will remain confidential. Though there may be a
possibility of a breach of your privacy, the investigator will use every means possible to guarantee confidentiality.
RIGHT TO REFUSE OR WITHDRAW
You can freely choose to take part in this survey and as much as possible your participation should not be
influenced by the researcher’s position, and you should not feel threatened. Should you decide not to join, it will
not be taken against you. There will be no penalty or loss of benefits for either decision. If you agree to participate,
you may stop at any time.
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WHO TO CONTACT?
If you have any questions at any time about this study, or you experience adverse effects as the result of
participating in this study, you may contact the researcher whose contact information is provided below:
Name: (name sa classmate na lalaki ra)
Mobile No.: lalaki na member nu
PART II: CERTIFICATE OF CONSENT
I have read the foregoing information, or it has been read to me. I have had the opportunity to ask questions
about it, and all my questions have been answered to my satisfaction. I voluntarily consent to participate in this
study.
Print Name of Participant : __________________
Signature of Participant : __________________
Date : __________________
STATEMENT BY THE RESEARCHER OR PERSON TAKING CONSENT
I have accurately read out the information sheet to the potential participant, and to the best of my ability made sure
that the participant understands that the following will be done:
1. Answering survey questionnaires as a participant of the study.
2. Assuring and securing the privacy, confidentiality, and anonymity in the conduct of the study
3. Keeping and destroying of the data responses, recording and transcript as specified in the study protocol.
I confirm that the participant was given an opportunity to ask questions about the study, and all the
questions asked by the participant have been answered correctly and to the best of my ability. I confirm that
the individual has not been coerced into giving consent, and the consent has been given freely and
voluntarily.
A copy of this Informed Consent Form has been provided to the participant.
Print Name of Researcher or person taking the consent:
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Signature of Researcher or person taking the consent
Date: 08/29/2024
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