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25-084249-01 UK & USA Culture & Nutrition_ADULT Consent Form

ADULT (16 AND OVER) PHOTOGRAPH/FILMING CONSENT FORM

Thank you for your interest in taking part in this research, which is completely voluntary. If you do take part, and if you give us your explicit consent, video and audio recording, and/or photography of you taking part will take place. These recordings and photographs may be used in private presentations of the research findings to Ipsos staff and stakeholders and the staff, stakeholders and creative agency partners of The Study Sponsor for research, insight, and training purposes. Please note that we may also store the photographs and recordings on our, or our subcontractors’, systems that will be hosted outside the European Economic Area.

Please note that when Ipsos UK is obtaining information from you during the research, Ipsos UK might collect special categories of personal data from you (including, for example, information you may choose to share about your racial or ethnic origin, political opinions, religious or philosophical beliefs, health or sexual orientation). If we capture any special categories of personal data, we will process that data under your explicit consent. Ipsos UK might, with your explicit consent, share this information with The Study Sponsor, if this information fits the purpose of this research.

Please be assured that any research recordings and photographs will be held by Ipsos UK and The Study Sponsor in strict confidence solely for the purposes described above and will be securely destroyed once they are no longer needed.

If you are happy to take part, and for the video and audio recordings and/or photographs to be used in this way, please read the below, complete the tick boxes as appropriate, and provide your signature and details.

The research has been explained to me, and I have been given a full explanation about the possible uses of any video and audio recordings and/or photographs of me arising from this research. I have also been given a copy of the project’s privacy notice. I want to take part in the research.		Yes No
I consent to the video and audio recordings and/or photographs of me being shared with and used by The Study Sponsor for the purposes described above.		Yes No
I understand that this research might involve the collection of special categories of personal data (such as information I may choose to share about my racial or ethnic origin, political opinions, religious or philosophical beliefs, health or sexual orientation), and I agree to Ipsos UK recording and processing this information about me.		Yes No
I consent to special categories of personal data being transferred to The Study Sponsor, where this information fits the purpose of this research.		Yes No
Are you happy for Ipsos to re-contact you regarding this research?		Yes No
Are you happy for your first name to be included in a caption with the audio and video recordings and/or photographs?		Yes No
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Please retain for future reference: If you have any questions, please call contact Ipsos UK Ethnography on +44 (0)20 3059 5000 or at [email protected] and quote: 25-084249-01 UK & USA Culture & Nutrition.

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March 12, 2026 3:57 pm BST

25-084249-01 UK & USA Culture & Nutrition_ADULT Consent Form Uploaded by Valeria Ordaz - [email protected] IP 212.42.190.49

March 12, 2026 4:07 pm BST

Val O - [email protected] added by Valeria Ordaz - [email protected] as a CC'd Recipient Ip: 212.42.190.49