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WellbeingUCL Data Collection

CONFIDENTIALITY AGREEMENT AND CONSENT FORM

Please read through this document carefully, before being measured by the 3D Body Scanner and other devices, which gives us your permission to use your data
DATA PROTECTION

Your personal data (as defined in the Data Protection Act 1998, which may include your 3D body scans, all measurements collected and research data) may be used by University College London (UCL) and its agents, collectively and individually. In legal terms, all such parties will be data controllers of the data and may process the data for data analysis and research purposes. Your data will be anonymised and held on a secure database for the duration of the project and will be deleted once the data is no longer required.

The information is confidential, and you may request a copy of your personal data by asking for a hard-copy print out in the future, for a small charge.

You will be given a report of your measurement for participating.


Report Received

MEASURED BY

3D BODY SCANNERS

To automatically measure your body the 3D body scanner is a photo-booth that uses safe, flashing lights. If you experience any problems with flashing lights or suffer from Epilepsy please advise staff at your body scanning session before you are scanned.

BODY COMPOSITION MONITOR

Your body composition will be measured using a Tanita body composition monitor which is the standard device used by UCL researchers to measure body composition.

HEALTH MONITORS

Health monitors will be used to measure your blood pressure and lung function.

CONFIDENTIALITY

By signing this agreement you agree to keep confidential, and not to disclose to any third party, any non-public information in relation to these studies.

INTELLECTUAL PROPERTY
All intellectual property rights created by, or in relation to this study, of which your body scans, measurements and research data form part, will vest in University College London.

Please enter your personal details below then sign and date the form to show that you have read and accepted the terms above.

NAME

AGE
GENDER - Male
Female
DATE

ETHNICITY - Caucasian
Black
Asian
Other

SIGNATURE
PARENT/GUARDIAN

Prof. Nick Tyler, Department of Civil Engineering UCL, tel: 020 7679 1562, email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it
Prof. Philip Treleaven, Department of Computer Science UCL, tel: 020 7679 7288, email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it