Assessment of Visual Memory and Learning by Selective Reminding Page: 57
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57
Appendix D
Informed Consent Agreement
Information About: Assessment of Visual Memory and Learning
by Selective Reminding
Principal Investigator: Shirley Cummins, M.A. 689-1900 x2673
The purpose of this study is to determine whether patients
having different types of neurological disorders will perform
differently on verbal and visual memory and learning tasks.
I understand that I will be asked to complete a verbal
and a visual memory and learning task and take a short test.
There are no risks associated with these procedures.
There may be some inconvenience, in that these procedures
take a certain amount of time and attention.
These procedures may provide information about the assess-
ment of verbal and visual memory and learning. If they do,
then they may be useful in diagnosisng memory deficits and
planning rehabilitation programs for patients who have memory
problems.
Authorized investigators may review my medical records.
I understand that the results of the study may be published
in the medical/psychological literature, but that my identity
will not be disclosed.
If I have any questions about this study, the investigators
will be glad to answer them for me. I understand that I am
free to withdraw my consent and discontinue my participation in
this study at any time. My participation in the study or with-
drawal from it will in no way effect my continued care and
treatment.
I have read the above and understand it and hereby consent
to the procedures set forth above.
Date Subject
Witness Principal Investigator
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Cummins, Shirley Jean. Assessment of Visual Memory and Learning by Selective Reminding, dissertation, August 1983; Denton, Texas. (https://digital.library.unt.edu/ark:/67531/metadc330808/m1/65/: accessed July 17, 2024), University of North Texas Libraries, UNT Digital Library, https://digital.library.unt.edu; .