A Review of Brydges Duty Counsel Services in Canada

Appendix D - Subject Feedback Form

Completion of this form is OPTIONAL, and is not a requirement of participation in the project. However, if you have served as a subject in a project and would care to comment on the procedures involved, you may complete the following form and send it to the Chair, University Research Ethics Review Committee. All information received will be treated in a strictly confidential manner.

Name of Principal Investigator:

Title of Project:


Did you sign or verbally consented before participating in the project ?:

Were there significant deviations from the originally stated procedures ?:

I wish to comment on my involvement in the above project which took place:

(Date) (Place) (Time)


Completion of this section is optional

Your name:


Telephone: (w) (h)

This form should be sent to the Chair, University Research Ethics Review Committee, c/o Office of the Vice-President, Research, Simon Fraser University, Burnaby, BC, V5A 1S6.