Professional Documents
Culture Documents
U n i v e r s i t y o f B o h o l
CP Office, Second Floor UB Administration Building,
Dr. Cecilio Putong Street, 6300 Tagbilaran City, Bohol,
Philippines ☎ (038) 411-3484 (local 804)
CUSTODIO, LISSEL B., FAJARDO, ZIALME A., LIM, KISSY MAE B., PALITEC,
JONATHAN C., PALOMARES, YVONE., PON, SHEMILYN., RAUT, ALYANNA
MARIELLE M.
We, the 4th year students of the College of Pharmacy conducting a study
regarding Community Pharmacist’s knowledge, awareness and perceptions
about smoking cessation as one of our requirements for the degree Bachelor
of Science in Pharmacy. In line with this, we would like to request your
participation by answering our survey. This study aims to measure the
Community Pharmacist’s knowledge, awareness and perceptions towards
smoking cessation i9n order to better understand the existing stigma that is
a barrier to delivering professional service.
All your answers and information will be seen only by the researchers and
kept confidential from other persons. The findings of this research will be
made available to all interested individuals who intended to know more
about topic. Again, your participation must be voluntary and you may
withdraw from the study at any time.
You may contact Ms. Alyanna Marille M. Raut at 09152321612 for any
questions or concerns regarding the matter.
CERTIFICATE OF CONSENT
I have read the foregoing information, or it has been read to me. I have had
the opportunity to ask questions about it and any questions I have been
asked have been answered to my satisfaction. I consent voluntarily to be a
respondent in this study.
Name of respondent:
Signature of respondent:
Date:
Name of researcher:
Signature of researcher:
Date: