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

Home Energy Consent Form

What you need to know to take part in
C111006331 Maintenance Appointments Smart Meters

Thank you for agreeing to speak with Verian Group UK Ltd (‘Verian’) about this research work for DESNZ where we will talk about your views on the steps you take to cool your home during heatwaves.

Please read this email in full and if there is anything you do not understand, let us know and we can help answer any questions you may have, before you take part.

Incentive voucher

As a thank you for your time, you will get a £50 voucher

Please see the email from your recruiter which tells you how you will get this incentive.

We must tell you

Our client, DESNZ is the Data Controller.

Verian is a member of the Market Research Society and ESOMAR and follow their research industry codes of conduct.

Verian will never pass your personal details to a third party without your permission.

Happy to take part?

Please read the information provided, and if you wish to take part, sign the form at the end

‘I have read all the information and agree to take part.’

PARTICIPANT PRIVACY NOTICE & TERMS C111006331 Maintenance Appointments Smart Meters

I understand that I do not have to take part and can change my mind and stop taking part at any time without giving a reason.

I understand Verian will collect the following personal data:
	Including my name, email address, and telephone number; for the following purposes: To give me any incentive voucher or payment. For quality control e.g. check I am the right person. If I agree to be contacted again by Verian about this project, within 12 months of this date.
	My voice, opinions and image will be recorded.
	My voice, opinions and image will be recorded, listened to and viewed by members of the Verian project team.
	I understand that I have legal rights to my Personal Data and can ask Verian for certain things, e.g. access to it, amend and/ or erase it. I can do this by contacting Verian at [email protected]. I can check Verian’s privacy policy here: https://www.veriangroup.com/uk-surveys

If you are unsure of the meaning of any information provided to you, please contact your recruiter or Maine Charlton for further clarity.

My agreement

I understand that ideas and or materials may be shared with me which are private and confidential and not available to the public (‘Confidential Information’). I understand it is important that this Confidential Information remains private, and I agree not to tell anyone else about it, without Verian’s permission. This includes not sharing any information with my family, friends, colleagues or others, and means I must also not share anything on social media/networks, instant messaging etc.

Please confirm the following -

‘I have read all the information and agree to take part.’

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

January 13, 2026 4:39 pm BST

Home Energy Consent Form Uploaded by Maya Mitchell-King - [email protected] IP 212.42.190.49

January 13, 2026 4:47 pm BST

Take Part in Research - [email protected] added by Maya Mitchell-King - [email protected] as a CC'd Recipient Ip: 82.148.32.25