Research project rough draft

San Francisco State University

Informed Consent to Participate in a Class Project

Asian Americans Living with a Chronic Illness

A. PURPOSE AND BACKGROUND

The purpose of this class project is to do interviews with you. The investigator is an undergraduate student at San Francisco State University, conducting this study for an Asian American studies course, Asian American Health. You are being asked to participate in this project because you are an Asian American living with a chronic illness or health condition.

PROCEDURES

If you agree to participate in this project, the following will occur:

· you will be interviewed for approximately 20 minutes to 40 minutes about including when you were diagnosed and the support you have received.

· the interview will be audiotaped to ensure accuracy in reporting your statements.

· the interview will take place at a time and location convenient to you

· This information will be used to assist in a paper that will be submitted to the instructor.

PARTICIPATION IN THIS PROJECT IS VOLUNTARY. You are free to decline to participate in this project, or to withdraw your participation at any point, without penalty.

If you have questions regarding this project, you may contact Professor Mai-Nhung Le at 415-338-6161 or [email protected].

Signature _____________________________ Date: _________

Project Participant

Signature _____________________________ Date: _________

Student Investigator