I agree to take part in the above City University London research project.

I have had the project explained to me, and I have read the participant information sheet, which I may keep for my records.

I understand this will involve:

Using a computer to diagnose and manage a virtual patient

Completing a questionnaire asking basic personal information (Age & Gender), educational qualifications and practice type information

Completing a questionnaire asking me about my experience using the decision support software

This information will be held and processed for the following purpose(s):

I understand that any information I provide is confidential, and that no information that could lead to the identification of any individual will be disclosed in any reports on the project, or to any other party.

No identifiable personal data will be published.

The identifiable data will not be shared with any other organisation or individuals including my employers or colleagues.

I understand that my participation is voluntary, that I can choose not to participate in part or all of the project, and that I can withdraw at any stage of the project without being penalized or disadvantaged in any way.

I agree to City University London recording and processing this information about me.

I understand that this information will be used only for the purpose(s) set out in this statement and my consent is conditional on the University complying with its duties and obligations under the Data Protection Act 1998.