APPENDIX C-3 MINORS ASSENT

I have read and understand the consent form and I agree to participate in this research study entitled Life after Fire: Chronicles Burn Survivors with the purpose of exploring the lived experiences of burn survivors. I know that I will receive a copy of this form in which I will participate, but I understand that this consent does not take away my rights and my parents rights in this study. As I participate in this study, I and my parents are fully aware of the possible risks. I know that the interview will include asking me personal questions about my burn experience, but I am willing to expose some of my private information to the researchers as long as my parents permit it and to extent that I approve to answer it. I am also willing to share my time with them until they finish their research study. With the information I have read from the above statements, I as a minor informant, I am well- assured that out of this study, I can gain benefits which could contribute to the improvement of the way people deal with and the way of living as burn survivors. And that information provided by me will be considered of the same importance as to the non-minor informants. My decision whether or not to participate will not prejudice my future relations with University of San Jose-Recoletos, College of Nursing. If I decided to participate, I am free to withdraw at any time without penalty. Moreover, my parents have the right to terminate my involvement from the study without due consequences. I have understood the explanation provided to me. I have had my entire questions answered to my satisfaction. Therefore, I voluntarily express my approval to be part of this study as long as my parents permit it.

_____________________________ Minors Signature over Name _____________________________ Witness Signature over Name

_____________________________ Researchers Signature over Name _____________________________ Date of Signing