Research Participant Confidentiality Agreement

This Confidentiality Agreement ("Agreement") is entered into between the Researcher and the Participant in connection with participation in the following research study:

1. Purpose

2. Confidential Information

3. Obligations

4. Exceptions

5. Duration

6. Agreement

By signing below, the Participant acknowledges understanding and agreement to the terms above.

Participant Name

Signature

Date

Researcher Name

Signature

Date