Ethics & Your Rights Short Consent Form BSL Principal investigator (project leader): Dr Christopher Shank, email: c.shank@bangor.ac.uk mobile/WhatsApp 07591 448751 Research project name: Deaf Health Wales Institution: Bangor University Funding: Arts and Humanities Mobilising Community Assets to Tackle Health Inequalities Have a problem? Email: cahssethics@bangor.ac.uk This consent form is for the following activity/activities: on By signing this form, I acknowledge (please ✔): I have been informed about the project in BSL, English and/or Welsh. My questions have been fully answered. I give my permission for my feedback to be noted and/or for me to be filmed or recorded. My recordings will only be accessed by the principal investigator and research team. I can withdraw from the study at any time before anonymisation, and I do not have to give any reasons. I allow the principal investigator and the research team to use the materials for written publications and presentations in relation to the project, such as the project website, journal articles, book chapters. I understand that my name and face will not be used in the publications. Your Name (please print) Email Phone Date Signature Clear