Your child and you have been invited to participate in a class

Your child and you have been invited to participate in a class assignment conducted by LPN student from CHCA Surrey, BC, Gurpreet Kaur. The purpose of this interview is to help the nursing students to determine child-directed communication styles during mutual storytelling. Procedure to be followed: Mutual story telling by your child and a student nurse. The interview will be recorded, and the reason for recording the story telling is to assess styles and communication skills of your child. It is by no means to be used to examine or test the behavior of your child. Risk or Discomfort: During the interview there is no foreseeable discomfort or danger to your child or the parent.Incentives: There will be no direct benefit to your child. But, he/she will receive a small gift for participating in the interview.Time & Place: Your child’s participation in the mutual story telling will not exceed 20-30 minutes at my place.Termination of participation: If at any point during the interview you or your child wishes to end the session, we will do so accordingly.Statement of confidentiality: All information obtained during the interview will be kept confidential and will be available only for study purposes. Your child’s identification will not be disclosed publicly. This interview will be reviewed and approved by a CHCA instructor. If at any time before, during or after the interview your child experiences any physical or emotional discomfort that is a result of his/her participation in the interview, or if you have any questions or concerns about recoding the story telling, please don’t hesitate to contact us. I, the Parent or Guardian of _______________________________, a minor who is ______ years of age, permits his/her participation in mutual storytelling, an assignment conducted by Gurpreet Kaur, a student nurse._________________________________ _________________ Signature of Parent or Guardian Date ________________________________________________

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