Consent Form

The aim of the study is to investigate long term memory.  You will be asked to read and memorize a list of words. You will then be given 90 seconds to write down as many words as you can remember. Some of the words may have strong emotional associations and may be disturbing for some people. If at any time you wish to withdraw yourself or your data from the study, you may do so without penalty, by simply stopping the video and emailing the researcher. You will not be required to state the reason that you do not wish to continue.  Please be assured that all data is anonymous and will be kept confidentially; it will not be disclosed to a 3rd party. If you have any questions about the research, please email one of the researchers, Rebecca Cooper: [email protected] or Jacqueline Cox: [email protected]

I have read and understood the above information and I am willing to take part in the research study.

Signed _________________________

Name __________________________

Date ___________________________