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consent_form.html
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consent_form.html
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<!DOCTYPE html>
<html>
<body>
<h1>A serious game to study the effect of limited field of view in keyhole surgery.</h1>
This research project aims to design and deploy a serious web-based game to study the effect of limited field of view in endoscopic (keyhole) surgery. Surgeons use endoscopes to relay real-time images to a monitor to help them manipulate their way around the body, however there is a limited field of view. There is currently very little quantitative data around the effects of limited field of view in endoscopic surgery. Therefore, this work aims to acquire relevant and meaningful data, as well as educate people on this limitation via a novel and engaging game.
You are being invited to take part in a research project to study the effect of limited field of view in keyhole surgery. I confirm that I understand that by ticking each box below I am consenting to this element of the study.
<br><br>
<form action="/action_page.php">
<input type="checkbox" id="pi_form" name="pi_form" value="pi_form">
<label for="pi_form"> I confirm that I have read and understood the Information Sheet for the above study. I have had an opportunity to consider the information and understand what will be expected of me and that if I had any questions they have been answered to my satisfaction. I agree to take part in a usability study.
</label><br><br>
<input type="checkbox" id="data" name="data" value="data">
<label for="data"> I understand that data will be anonymised and that it will not be possible to link my personal data (consent, contact details) with the study data. I understand that according to data protection legislation, task in the public interest will be the lawful basis for processing.
</label><br><br>
<input type="checkbox" id="confidential" name="confidential" value="confidential">
<label for="confidential"> I understand that all personal information will remain confidential and that all efforts will be made to ensure I cannot be identified. Data gathered in this study will be stored anonymously. It will not be possible to identify me in any publications.
</label><br><br>
<input type="checkbox" id="review" name="review" value="review">
<label for="review"> I understand that my information may be subject to review by responsible individuals from the University for monitoring and audit purposes.
</label><br><br>
<input type="checkbox" id="benefit" name="benefit" value="benefit">
<label for="benefit">I understand that I will not benefit financially from this study or from any possible outcome it may result in in the future.
</label><br><br>
<input type="checkbox" id="compensate" name="compensate" value="compensate">
<label for="compensate">I understand that I will not be compensated for the portion of time spent in the study if I choose to withdraw.
</label><br><br>
<input type="checkbox" id="future" name="future" value="future">
<label for="future"> I agree that my anonymised research data may be used by others for future research. [No one will be able to identify you when this data is shared.]
</label><br><br>
<input type="checkbox" id="report" name="report" value="report">
<label for="report"> I understand that the information I have submitted will be published as a report.
</label><br><br>
<input type="checkbox" id="who" name="who" value="who">
<label for="who"> I am aware of who I should contact if I wish to lodge a complaint.
</label><br><br>
<!--input type="submit" value="Proceed to Study"-->
</form>
<button onclick="window.location.href='./index.html';">Proceed to Study</button>
</body>
</html>