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SayPro Interview Consent & Ethics Checklist
SayPro Interview Consent & Ethics Checklist
SECTION A: Interview Details
- Project/Case Study Title:
[Insert project title] - Researcher/Interviewer Name:
[Full name of interviewer] - Date of Interview:
[DD/MM/YYYY] - Interviewee Code/Initials (for anonymity):
[e.g., F01, J.S., etc.]
SECTION B: Informed Consent Checklist
Before conducting the interview, the interviewer must:
| # | Consent Criteria | Confirmed? (✓) |
|---|---|---|
| 1 | Clearly explained the purpose of the interview and its voluntary nature | ☐ |
| 2 | Clarified how the information will be used (e.g., report, internal learning) | ☐ |
| 3 | Explained the participant’s right to refuse or withdraw at any time | ☐ |
| 4 | Confirmed that participation will not affect access to SayPro services | ☐ |
| 5 | Outlined steps to ensure confidentiality and anonymity | ☐ |
| 6 | Explained how the interview will be recorded (if applicable) | ☐ |
| 7 | Gained verbal or written permission to use direct quotes anonymously | ☐ |
| 8 | Obtained permission to take photos (if applicable) | ☐ |
| 9 | Provided opportunity to ask questions and receive clear answers | ☐ |
| 10 | Gave a copy of the consent form if requested | ☐ |
SECTION C: Consent Confirmation
- Type of Consent Obtained:
- ☐ Verbal
- ☐ Written
- ☐ Not Applicable (data already public or non-personal)
- Photo/Video Consent:
- ☐ Yes – For internal use
- ☐ Yes – For public use (e.g., reports, website)
- ☐ No
SECTION D: Additional Ethics Considerations
| Criteria | Addressed? |
|---|---|
| Cultural appropriateness of language and approach | ☐ Yes |
| Gender-sensitive approach used | ☐ Yes |
| Consent given without pressure or coercion | ☐ Yes |
| Interview conducted in a safe and private environment | ☐ Yes |
| Interview avoided emotionally harmful or sensitive lines of questioning | ☐ Yes |
| Appropriate referrals available if distress or trauma is triggered (if needed) | ☐ Yes |
SECTION E: Interviewer Declaration
I confirm that all relevant ethical considerations have been respected, and the participant voluntarily agreed to be interviewed.
Name of Interviewer: ____________________
Signature: _____________________________
Date: _________________________________
SECTION F: Participant Declaration (for written consent)
I understand the purpose of the interview and how the information I provide will be used. I give my voluntary consent to participate in this case study research.
Name of Participant: ____________________
Signature (or mark): ____________________
Date: _________________________________
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