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Claremont - Food and Environment - Consent Form

Project Name - Essex County Council – Food Environment

Please read the following statements and confirm the following:

I understand that taking part is voluntary and that I can stop at any time. Stopping will not affect any ECC services I use or the payment for that session. However, I understand that if I choose not to attend consequent sessions, I won’t be paid for these.

YES

I have read Claremont’s privacy notice. I agree to take part and allow my personal data to be collected, stored, and used for this research.

YES

I understand that Brunel University is a research partner in this project. I agree to take part in pre- and post-surveys. I understand that anonymised data from this will be shared with Brunel University.

YES

I know I can withdraw my consent at any time. If I want my data removed, I must email Olivia ([email protected]) before the Citizen Circles end on 10 April 2026.

YES

I agree to this session being videorecorded, including audio. I understand that this will be turned into an anonymous transcript. I understand how my data will be used, stored, shared, and deleted.

YES

I understand that ECC staff and partner organisations may review the research data with my consent. I understand that none of my personal details (like my name or address) will be shared with them.

YES

I understand how my data may be used in research, publications, and archiving. I can request access to my data by contacting Olivia.

YES

I understand that ECC, Claremont and Brunel University may publish the research findings. I understand that nothing will identify me or any organisation.

YES

I understand my information will be used to gather views for this research, and that insights may be used in other related projects.

YES

I understand that if I mention something that suggests I or someone else may be at risk of harm, the researcher must inform safeguarding or support services. They will speak to me first if this happens.

YES

I agree to respect other participants by keeping everything shared in the discussion private.

YES

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Timestamp

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March 13, 2026 9:44 am BST

Claremont - Food and Environment - Consent Form Uploaded by Amy Bickers - [email protected] IP 212.42.190.49

March 13, 2026 10:30 am BST

Take Part in Research - [email protected] added by Amy Bickers - [email protected] as a CC'd Recipient Ip: 212.42.190.49