Request edit access
Usability Testing - Parkinson's Connect Consent Form
Thanks for taking time to help us!

We’ll be showing you a prototype of a new online experience and asking for your feedback. We call this usability testing. This prototype is a rough mock up that is not yet built. The reason we’re showing you this is to get feedback before the team builds the real version. We’ll be providing you with a few tasks to role play as your use the prototype. Please think out loud as you use the prototype. The research will take around 40 minutes. We are in no way testing you; this is all about the prototype and what works and what doesn't so feel free to speak your mind.The research will take around 40 minutes.

About Parkinson's Connect User Research
Parkinson’s UK is conducting research to help improve our information and support services. The reason we want to do this is to understand how people are supporting themselves and what support we can offer. This is different from the Research carried out through clinical trials.

Your rights
You can request a copy of your information at any time. You have the right to withdraw your consent at any time. If you wish to withdraw your consent, please use the contact details below.

Recording the session
We may like to take notes and/or take an audio or video recording of our interviews to help us remember what we talked about. We will only do this if you give us your consent by email.

How we store your information
We will securely store any information you submit through this form. Only Parkinson’s UK will have access to it. If at any time you decide that you do not want us to store information about you, please let us know and we will delete it.

How we use your information
We will use the information on this form to contact you and arrange further participation if suitable. We may use information such as your age or connection to Parkinson's to report on the research. We only share the information with people who work at Parkinson's UK. We anonymize information so others will not be able to identify you.

If we record the research session, we will delete the recording once we have analysed the data. If we use quotations from your interview when we share the research within Parkinson's UK, will not use your name alongside the quote. We will securely store any data collected for this research. Only the research team will have access to this data, and we will keep your personal contact details separate from your interview. We will encrypt the files on our network.

Like to get involved?
We have an ongoing programme of user research at the heart of our service redesign. We’d love to hear from you whether you have Parkinson’s, or are a carer, family member or friend of someone who does. We celebrate diversity and are committed to creating inclusive services. We are especially interested in hearing from people from diverse groups.

If you have any questions about your participation, the research or how we use your information, please contact:

Yvette Bordley - Service User Involvement Coordinator
Phone: 07412 139341


By submitting this form you are agreeing on a staff member at Parkinson's UK to contact you in relation to your participation. At Parkinson’s UK we want to be very clear about how we use, store, and protect your personal data. You can read about it here:

Unless we explain otherwise to you, we will hold your personal information for as long as we have reasonable business needs, such as managing our relationship with you and managing our operations and based on retention periods in line with legal and regulatory requirements or guidance. Last updated Sept 2021.
Sign in to Google to save your progress. Learn more
Email *
Name *
Contact details (email address and or phone number) *
Date of consent *
Do you have any accessibility requirements?
How confident would you say you are with technology?
Clear selection
I have been informed of and understand the purpose of the research and am happy to take part. *
I understand that participation is voluntary and I can withdraw at any point. *
I am aware of how the information I provide will be used and presented in presentations and publications e.g. quotes. *
I give consent for my first name to be reported in association with research findings. *
Clear form
Never submit passwords through Google Forms.
This form was created inside of Parkinson's UK. Report Abuse