Consent for Survey Survey Consent Efficacy of Six-week Introductory Training (SIT) in Mindfulness Investigator: New Mindful Life 3367 4 th Ave San Diego CA 92103 www.newmindfullife.com Description: The purpose of this study is to measure the efficacy of the SIT Mindfulness course for managing stress and increasing emotional awareness. Mindfulness practices have been shown to be useful in these areas. The current study will measure SIT students’ stress and emotional awareness before, during and after the six-week course. Risks and Benefits: Mindfulness practices have been shown to be beneficial in managing the symptoms of stress, improving attention and memory, and supporting the experience of positive emotions. Mindfulness practices may result in minor discomfort from closing eyes, slow physical movements, and focusing on breath/body sensations. Also, talking about stressors may evoke physical and emotional discomfort. Time Commitment and Payment: All research for this study will take place within the SIT course. There is no additional time commitment and no payment for participating in the study. Confidentiality: Your survey responses will be collated by randomly assigned numerical IDs, not by your name. I do not believe that you can be identified from any of this information. This informed consent will not be kept with any of the documents completed for this project. No names will be used in the reporting of results. Right to Withdraw: Your participation in this study is entirely voluntary. You may chose not to participate without any adverse consequences to you. Should you choose to participate and later wish to withdraw from the study, you may discontinue your participation at that time without consequence. Statement of Consent: By signing this consent form you agree to participate in the project entitled, Efficacy of the Six-week Introductory Training in Mindfulness.Date MM slash DD slash YYYY Name First Last Signature Δ
