SayPro Interview Consent & Confidentiality Form

Interviewee Name: _________________________________________
Organization/Affiliation: ____________________________________
Date of Interview: __________________________________________
Interviewer Name: __________________________________________

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Purpose of the Interview

The purpose of this interview is to gather insights and perspectives to support SayPro’s ongoing projects and research initiatives.

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Consent

By signing below, you agree to participate in this interview voluntarily. You understand that:

• Your responses will be recorded and/or noted for accuracy.
• The information you provide will be used to inform SayPro’s programs and research.
• Your identity and responses will be treated with confidentiality and only shared with authorized personnel.
• You may choose to skip any questions or stop the interview at any time without consequence.
• With your permission, direct quotes may be used in reports, but your name and identity will be anonymized unless you explicitly agree otherwise.

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Confidentiality

SayPro commits to safeguarding your information and ensuring that data collected will not be used for purposes other than those stated without your consent.

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Permission for Recording

Do you consent to the interview being audio/video recorded?
☐ Yes
☐ No

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Agreement

I have read and understood the above information. I agree to participate in this interview under the stated terms.

Signature of Interviewee: _______________________________
Date: ____________________________

Signature of Interviewer: _______________________________
Date: ____________________________