You are about to take part in a market research survey, web assisted phone interview, or audio interview with screen sharing (and optional video/webcam) conducted by BEESY and its research partners, independent market research companies, on behalf of a pharmaceutical company. 

The purpose of the research is to understand your views regarding various healthcare treatment decisions. Please don’t mention any identifiable information during your interview (such as your full name or contact details) to protect your anonymity.

ADVERSE EVENTS, OTHER SAFETY INFORMATION AND PRODUCT COMPLAINTS
We are required to pass on to the sponsor the details of any adverse events, other safety information and/or product complaints (including actual and potential adverse events) that are mentioned during market research interviews. Should you mention an adverse event and/or product complaint, we will need to report the adverse event even if you have already reported it directly to the company or the regulatory authorities. You have the right to remain anonymous, and this will have no effect on the anonymity of the study.

You will receive an agreed upon honorarium for participating and completing the above-mentioned study, pursuant to the following terms and conditions:

1. I am over 18 years of age.

2. I understand this a blinded study and my identity will never be revealed to the study sponsor.

3. I have read and accepted BEESY’s Privacy Policy and Data Protection Rights

https://beesystrategy.com/privacy-policy 

4. I understand that BEESY and its research partners will comply with all international laws protecting my personal data, and also in accordance with the  CASRO, ESOMAR, EphMRA, MRS and BHBIA codes of conduct.

5. I agree to audio recording, video recording of my webcam (if you are using video) and video recording of the screen sharing of my interview. The video recording of your webcam (if you are using video) will only be accessible to BEESY and will not be shared with the sponsor or any third parties.  The recording is performed for the purposes of market research, insights and analysis. The audio recording, as well as as transcript of the interview, may be shared with the sponsor’s market research, insights and analysis teams for the purposes of market research, insights and analysis.

6. I understand that:

• By providing my information I won’t be contacted for non-research purposes.
• My participation in this study is voluntary. I may ask that the recording/observation be stopped at any time, decline to answer particular question, and/or withdraw at any time from the research without disadvantage.
• BEESY will not request, and I should not provide, any sensitive personal information.
• BEESY will anonymize my responses and aggregate them with the responses of other participants in order to share study results externally.
• BEESY will report any safety/adverse event information collected during the interview to the study sponsor.
• I have the right to refuse to provide my contact information to be further contacted by the study sponsor about reported safety/adverse events information.
• The interview may be observed live (including live webcam video if you are using a webcam and live video of the screen sharing) by personnel from the sponsoring pharmaceutical company (market research, insights and analysis teams) for market research, insights and analysis purposes and, if so, I give my consent.
• Any data collected during the research will be handled, processed and stored safely during the research and destroyed within 30 days of completion of the project.
• In order to allow BEESY or its research partners to call me at the time of the interview, my contact details (name and phone number) will be transferred to BEESY and their subcontractors. They will use this information exclusively for this purpose and will permanently delete these details once the interview is complete. BEESY and their subcontractors will not ask you for any contact details during the interview and will not ask you to register for any other services or platform, including but not limited to other market research panels.
• I have the right to request the deletion of any or all of my personal data from the database at any time.
• My personal data may be transferred to the US.
• I acknowledge receipt of the BEESY, LLC HIPAA Privacy Policy. https://beesystrategy.com/hipaa-privacy-policy 
• Any information I acquire or otherwise am exposed to during the research is CONFIDENTIAL information of BEESY and I will not disclose any such information to any third parties.

By proceeding with the research, you acknowledge that you have read and understand the terms of this consent form and agree to participate in this market research study. Your verbal confirmation before the start of the interview will serve as your agreement to these terms. You can withdraw your consent and participation at any time.

BEESY LLC. 

 
Luka Dragutinovic
Compliance Officer
(609) 532-4853