Consent form

We need consent so that we can analyse and publish the programme results. You do not have to do this to take part in the programme.

This is the form it takes:

Stockton Heath Medical Centre, The Forge Stockton Heath.

We would like to use anonymous data to help us and other doctors and nurses learn what can be done with low carb ways of eating. In this way, we hope that the knowledge of this method will spread throughout the country, enabling better health for many more people.

If you consent to sharing your anonymised data please sign a consent form and give the form to me when we next have a group meeting.

I hereby consent to the anonymous sharing of my data as part of the 8 week low carb behavioural change programme.

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Signature

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