WP E-Signature by Approve Me - Sign Documents Using WordPress -

Health and Wellness Retail Research Consent form

RECORDING, CONFIDENTIALITY SIGNATURE FORM

Job No: P045056
Job Title: Consumer Research

Methodology

Depth Interview

Observed

Audio

Video

Your personal information collected from the interview will remain confidential and will be used exclusively for the research project. Any use of such information will not include your full name or personal details. By signing below, you give your consent for the interview to be recorded on video and/or audio for purposes such as transcription and analysis. All videos will be used internally by Savanta and the end client and will not be made public. Such images or recordings may be retained until the expiration of the retention period.
"I agree that Savanta Group and their clients may use this video/audio material for research purposes."

Tick box to agree

As part of this study, you may be shown products and/or materials, or ideas or concepts may be discussed that are not yet publicly accessible. By signing, you agree to keep what was shown to you or discussed in the conversation confidential.
"I agree not to record, capture, or reproduce in any way the materials or ideas shown or discussed, including mentioning the client organization to any third party."

Tick box to agree

The Savanta Group is committed to processing personal data in accordance with the General Data Protection Regulation (GDPR) or other relevant local data protection laws. The personal data collected about me, both on this form and in other communications with Savanta, which can identify me, such as my name or contact details, will be securely stored.

Your personal information will not be shared with other companies unless you separately agree to it. You can request a copy of your personal data at any time and also request that your records be deleted from all electronic file servers. You and the Savanta Group can amend such records.
"I hereby confirm that I have read, understood, and accepted the above information."

Tick box to agree

PLEASE COMPLETE IN CAPITAL LETTERS:

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

Draw Signature
Type In Signature

Draw your signature with your mouse, tablet or smartphone Clear

I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

I agree that I am and I understand this is a legal representation of my signature

Adopt & Sign

Timestamp

Audit

May 15, 2025 1:50 pm BST

Health and Wellness Retail Research Consent form Uploaded by Maya Mitchell-King - [email protected] IP 151.230.228.89

May 15, 2025 1:56 pm BST

Take Part in Research - [email protected] added by Maya Mitchell-King - [email protected] as a CC'd Recipient Ip: 151.230.228.89

May 15, 2025 2:04 pm BST

Take Part in Research - [email protected] added by Maya Mitchell-King - [email protected] as a CC'd Recipient Ip: 151.230.228.89