* Example of a Disclaimer for use during a Market Research Interview – HCP

Interviewer says:
You are about to enter a market research interview. 'We are required to pass on to our client details of adverse events that are mentioned during the course of market research interviews. Although this is a market research interview and what you say will, of course, be treated in confidence, should you raise during the discussion an adverse event in a specific patient or group of patients, we will need to report this even if it has already been reported by you directly to the company or the regulatory authorities using the MHRA's 'Yellow Card' system. In such a situation you will be asked whether or not you are willing to waive the confidentiality given to you under the Market Research Codes of conduct specifically in relation to that adverse event. Everything else you say during the course of the interview will continue to remain confidential. Are you happy to proceed with the interview on this basis?’
So that this is absolutely clear, I would like you to now sign the following statement:

I, the undersigned: 1. Recognise that there is an obligation for the interviewer to collect details of any adverse events about individual patients or groups of patients that are mentioned during the course of these interviews. Although this is a market research interview, so that what is said is treated in confidence, should an adverse event in a specific patient or group of patients be mentioned in the discussion, the interviewer will need to collect this information and report it to their client even if the adverse reaction has already been reported into the national reporting system.

2. Agree that after the above explanation, I was given the option not to take part in this interview, if I had any reservations.

Signed ...................................................