ethics dementia group
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Therapeutic Arts & Gomplementary MedicineFaculty of Education, Health and Sciences
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Tiile or topic erea of proposed study
What are the aims and
Ac*esrsix 2 - Rs*uest for Ethical Asproval for lndividual Study /Programme of ResearchReouest.For Ethical Approval Fgr lndivic!r-ra! Stlrdrr I p:nqramr,o nfResearch
Your Name: ti -t.li l1+rrr-.'* o" r'' .r.-..:,r .., a.in.c" Cia..q... 1., I i SchoollResearch centre {if internal applicant}: FCr.lcation. Health and Sciences-tj*; ,. I tr^1 l;rr--_)1ll {8..,,
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Therapeutic Arts & Complementary Mediein+Faculty of Education, Health anci $ciencesO'-rtline of study design and methods
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age, and if appropriate, inclusion and exclusion Griteria'samplo, covering selection, number,
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irde to the participants? lf so, please givedetails below.What resources will you require? (e.g. questionnaires, equipme_nll {"1 example video Gamera,-*--:-r:-- r ^-3u-'^--. :' --"--r:----i-:5 61e io be used please give full details here).3 p; iAtiS!.tj lwl rrrcrr c; r I | \.1 lllrit rlvl I I lqll (
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hoiyouintendtoaddresseachofthefollowinginyouretudy}.ConsentDebriefing
\Mthdrawal from the investigationConfidentiali$Protection of participantsObservation research [complete if applicable]Giving advice
cbarancefromanyotherbody/organisation?YeslNo(please circle as appropriate)lf Yes - please give details below.
uesiofmyknowledgeandbelief,accurate'lclearlyunderstandmyobligations and the iignts of the participants. I agree to act at all times in accordance with University ofDerby Ethical Policy for conducting research with human participants.hala af a.rhmiaaian
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Therapeutlc Arts & Gomplementary MedicineFaculty of Education, Health and Sciences
,-i, .',.:1,'- f;:-!ai:1qT :t +:-.:l 'rr.:'lr!l r!:i: .'1,1i'LiCATIOl'l THE FOLLOWING DOCUMENTATIONv.uncxn Hi;'ijRilPxiHT E rprease llcK ro inciicate the material that has been included or provide informationaS ii.i VtiiV ri r:S iia)i ;iV;ii.lirie IComments:
Queetionnaires/lnterview sched ules: nCovering lettersllnformation sheets : nBriefing and dEbriefing material: nConsent forms for participante: trllA learning contract (lf applicable): n