Consent form for the DSS Safe Places Inclusion Round Interviews

Focus: Understanding how emergency accommodation can be more appropriate andaccessible for women & children who are victim-survivors of family and domestic violence.

1. I consent to allow the child to participate in this research, the details and purpose of which have been explained to me, and I have been provided with a written plain language statement. 

2. I understand that the child’s participation in this project is for research purposes. 

3. I understand that the child’s interview will not be audio-recorded, and interview notes will be taken instead. 

4. I understand that the child’s participation is voluntary, and they don’t have to participate if they don’t want to. 

5. I understand that my child’s personal information will remain confidential, and their name/identity will not be used by CIRCA in any written or verbal reports to DSS or anyone else outside of the CIRCA research team. 

6. I understand that if they requested it, a psychological support worker or support person of my child’s choosing may be present and hear details of the interview. 

7. I understand that after I sign and return this consent form, it will be retained by the research team.

Chief Investigator contact for the research

Lena Etuk (CIRCA)

Tel: 02 8585 1330 Email: lena@circaresearch.com.au