Attachment A. Human Subjects Consent Script

I, ______________________________, agree to take part in a research titled “Introduced Germplasm from Vietnam: Documentation, Acquisition, and presentation,” conducted by _________________________ from the Department of Anthropology at the University of Georgia under the direction of Dr. Robert Rhoades and Dr. Virginia Nazarea from the Department of Anthropology at the University of Georgia.  I do not have to take part in this study.  I can stop taking part at any time without giving any reason, and without penalty.  I can ask to have information related to me returned to me, removed from the research records, or destroyed.

The aim of this research is to preserve genetic and cultural diversity related to plants brought to the United States by Vietnamese immigrants and refugees.

If I volunteer to take part in this study, I will be asked to do the following things:
     1) Answer questions about my plants and my garden stories.
     2) If I am willing, the researcher will audio/videotape and photograph the interview.
         These recordings will be accessed by scientists, as well as being used for educational purposes.

I will benefit from this research because my knowledge and plants will be documented for future generations.

My identity will be withheld by giving me a pseudonym, if I so desire.  Any information that is obtained in connection with this study and that can be identified with me will be disclosed only with my permission or as required by law.  If I grant permission to record the interviews, I have the right to review and edit the audio/videotapes as well as the photographs.

The researcher will answer any further questions about the research, now or during the course of the project and can be reached by telephone at (706) 542-3852 or (706) 542-1042.

I understand the procedures described above.  My questions have been answered to my satisfaction, and I agree to participate in this study.  I have been given a  copy of this form.
 

_______________________                                        ___________________
Signature of Researcher                                                  Date
                                             

 

______________________                                          ____________________
Signature of Participant Date                                           Date

Or

For questions or problems about your rights please call or write: Chris A. Joseph, Ph.D., Human Subjects Office, University of Georgia, 606A Boyd Graduate Studies Research Center, Athens, Georgia 30602-7411; Telephone (706) 542-6514; E-mail IRB@uga.edu.
 
 
 

 
 

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