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Experiences and needs of mothers of babies diagnosed with Hypoxic Ischaemic Encephalopathy due to birth asphyxia

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Academic year: 2021

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Appendix B: Informed Consent Form

DECLARATION BY PARTICIPANT:

I, ……….., agree to participate in the research study entitled: The emotional responses and needs of mothers in the six to eight months after diagnosis of HIE due to asphyxia while giving birth.

I fully understand the information that was provided and all my questions have been

answered. I understand that my participation is voluntary and that I may withdraw from the study at any time. I understand that my information will be kept confidential and

anonymous.

Signed at ………. (place) On ………2013 (date)

………. ……… Signature or thumb print of participant Signature or thumb print of witness

DECLARATION BY INVESTIGATOR:

I, ………, declare that I explained all the information regarding the research project to the above-mentioned participant and I am satisfied that she understands all aspects of this study.

Signed at ……… (place) On ………2013 (date)

……… ……… Signature of investigator Signature or thumb print of witness

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