WEEK 10 PROJECT FINAL

INFORMED CONSENT LETTER

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SELF CONSENT

I have been invited to take part in a research study titled:

This investigation is spearheaded by Yulak Landa: whose contact information includes: [email protected] and (305)833-0053 I understand that my participation is voluntary and that I can refuse to participate or stop taking part any time without giving any reason and without facing any penalty. Additionally, I have the right to request the return, removal, or destruction of any information relating to me or my participation. I am aware that the participation in this research study is on a voluntary basis, and I am free to object the invitation as well as to withdraw my involvement as I would deem fit without offering any reason, getting victimized, or facing any legal suit or conviction. It is also my right to ask for the withdrawal, return, or discarding of any of the information shared or collected following my participation in the study. PURPOSE OF STUDY I understand that the purpose of the study is to: Determining how efficient are both the respiratory mask as well as standard mask in preventing healthcare providers from getting exposed to corona virus in the course of their work. Can they all be relied to offer the same protection? PROCEDURES I understand that if I volunteer to take part in this study, I will be asked to: Declare information related to chronic illness or preexisting conditions as well as my age. I will as well be required to fully adhere to the recommended hygiene standards as well as to be fully dressed with protective gears which include the designated face mask, prior to getting exposed to SARS- COV – 2 viruses. Also, I will have to undertake a 14 day or more in quarantine as well as undertake the COVID 19 test. I shall also be required to undertake necessary treatments in the event I am exposed to the virus. BENEFITS I understand that the benefits I may gain from participation include: I will get a chance to enhance the safety of healthcare providers' who continue to dedicate their efforts to the treatment and care of COVID_19 patients and relies on face masks as one of their PPE.

For Official Use Only Received on:

Reviewed on:

End date:

File Number:

INFORMED CONSENT LETTER

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I will assist them in understanding if they would still use the standard face masks, taking into consideration the general shortage of respiratory masks. All the instruments to be used and expenses incurred will be covered by the researcher together with any counseling and treatments in case I am exposed to the virus. RISKS I understand that the risks, discomforts, or stresses I may face during participation include: I understand that I may get exposed to the virus, become sick, or even die from the COVID 19 disease. Due to the gravity of the illness, I may also be psychologically affected. CONFIDENTIALITY I understand that the only people who will know that I am a research subject are members of the research team. No individually-identifiable information about me, or provided by me during the study will be shared with others except when necessary to protect the rights and welfare of myself and others (for example, if I am injured and need emergency care, if the provided information concerns suicide, homicide, or child abuse, or if revealing the information is required by law). FURTHER QUESTIONS I understand that any further questions that I have, now or during the course of the study can be directed to the researcher Yulak Landa. Additionally, I understand that questions or problems regarding my rights as a research participant can be addressed to Dr. Jessica Hillyer, Institutional Review Board Director of Compliance and Training, South University, 7700 W. Parmer Ln., Austin, TX 78729; [email protected]; 512-516-8779. My signature below indicates that the researchers have satisfactorily answered all of my current questions about this study and that I understand the purpose, procedures, benefits, and risks described above. I have also been offered a copy of this form to keep for my own records. Yulak Landa Name of the Participant Yulak Landa 05/23/2020 Participants Signature Date (dd/mm/yyyy) Principal Researcher Signature Date (dd/mm/yyyy)