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Participant Consent Form

Consent form - Neurotech Research Project
This form records your consent to participate in the Neurotech Research Project and to the
use of your personal information as described in the Participant Information Sheet -
Neurotechnology Workshops.

Please make sure you have fully read and understood the Participant Information
Sheet - Neurotechnology Workshops before completing this form.

Please read each statement carefully, and select yes if you agree with it.

I have read and understood the Participant Information Sheet -
Neurotechnology Workshops.

Yes, I agree

No, I don't agree

I agree to take part in the Neurotechnology workshops.

Yes, I agree

No, I don't agree

I consent to the use of my personal information as described in
the Participant Information Sheet - Neurotechnology
Workshops

Yes, I agree

No, I don't agree

Important information
You can withdraw from the research project at any time by using the contact details below.
You can also withdraw your consent to the use of your personal information at any time by using the contact details below. If you do this your participation in the research project will end and we will delete your personal information. Please note that, once the project data has been anonymised, we will no longer be able to delete your personal information because it will no longer identify you.

Contact details: Aleks Berditchevskaia ([email protected])

Date:

Nesta, 58 Victoria Embankment, London, EC4Y 0DS
Registered as a charity in England and Wales 1144091 and Scotland SC04283

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Timestamp

Audit

March 6, 2026 5:02 pm BST

Participant Consent Form Uploaded by Valeria Ordaz - [email protected] IP 212.42.190.49

March 6, 2026 5:06 pm BST

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