CleanBC Go Electric Consent Form

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Research consent form for Go Electric interviews for commercial/industry/government stakeholders.

The CleanBC Go Electric team are conducting research to better understand the needs and experiences of people in British Columbia (B.C.) when using the Go Electric website. As part of this work, we are talking to people to understand more about how we can improve the Go Electric website.
 
The information you provide will be anonymous. We will summarize all responses in terms such as “We heard from stakeholders that…”, without referring to any single person.
 
The call will be attended by an interviewer and a notetaker. There may also be one additional observer. 
 
Recording and Transcripts
With your consent, your interview session will be recorded. Your name and other identifiers will not be associated with the recording, nor will the recording be used for any purpose other than those described in this form or otherwise permitted by law. 
 
All recordings, transcripts and notes will be stored for the duration of the project and then securely disposed of as transitory records in accordance with the Information Management Act and related policies.   
 
Confidentiality
Your confidentiality will be respected. We will de-identify all notes and ask that you not name yourself or others in audio or video recordings.
 
In capturing individuals’ stories and experiences, personal information of a confidential nature may be shared during the interview. In compliance with the Freedom of Information and Protection of Privacy Act, all personal information will be protected using appropriate security controls.
 
Collection Notification
This information is collected by the Ministry of Citizens’ Services – GDX under section 26(c) and 26(e) of the Freedom of Information and Protection of Privacy Act, and will be used for the purpose of assisting analysis in the project described above. It may be used for training or evaluation purposes. If you have questions about how your information is used, please contact:
 
Anushka Agrawal
Service Design Researcher

I agree to being audio recorded for the purposes described.
Please select an option
I agree to screen capture recording for the purposes described.
Please select an option
I agree to being video recorded for the purposes described.
Please select an option

As a participant in our interviews, we want to ensure you feel respected, safe and supported at all times. If there is anything the team can do to make the interview more comfortable for you, please email us. You are not required to take part in our interviews, and you can end the interview session at any time. If you end the interview session early, you are still entitled to a gift card. 
Please accept the terms.
It’s important that our team also feels safe and respected in our interviews, free from insulting, abusive or inappropriate language and threatening behaviour. If the team does not feel safe in the interview session for any reason, they may end the session early. If the team ends the session early, you are still entitled to a gift card.
Please accept the terms.
I understand the following:
  • I have read and understood the Participant Consent form
  • I have had the opportunity to ask questions and have had satisfactory responses to my questions
  • I will receive a dated and signed copy of this form
Missing or incorrect value
Missing or incorrect value
Date Missing or incorrect value
Please accept the terms.

We'd like to provide you a gift card to thank you for taking the time to participate in this research.
 
You will receive a $40 electronic gift card by email from Virtual Incentives after the session. You will have the option to choose the type of gift card you want.
 
You are entitled to the gift card regardless of you completing the session.
e-Gift Card Collection Notification
Your personal information is collected through Virtual Incentives under section 26(c) and section 26 (e) of the Freedom of Information and Protection of Privacy Act, for the purpose of delivering and confirming that you have received your e-Gift card.
 
Registration of your e-Gift card through Virtual Incentives is voluntary. Please be aware that your IP address, email address and e-Gift details will be collected by Virtual Incentives, and this information will be stored and may be accessed outside of Canada. By selecting "yes" you are consenting to your personal information (IP address, email address and e-Gift details) being stored and/or potentially accessed outside Canada. Your consent is effective as soon as you submit.
 
If you have any questions about the collection, use or disclosure of your personal information, please contact:
 
Anushka Agrawal
Service Design Researcher

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