SayPro Ethics Compliance Form

Project/Programme Title:
_______________________________________________

Principal Researcher/Project Lead:
_______________________________________________

Date of Submission:
_______________________________________________

SayPro Reference Number (if applicable):
_______________________________________________

---

1.SayPro Researcher/Facilitator Details

Name	Role	Contact Information

---

2.SayPro Project Description

Briefly describe the purpose of the project, its scope, the target population, and intended outcomes.

---

3.SayPro Ethical Principles Compliance

Please confirm the following by ticking ✓ where applicable and providing explanations or documentation where required.

Ethical Principle	Yes	No	Comments / Supporting Information
Informed consent will be obtained from all participants			Attach sample consent form
Participation is voluntary and participants may withdraw at any time
Participant confidentiality and privacy will be maintained			Describe data protection measures
Data collected will be securely stored and anonymized
Project involves vulnerable populations (e.g., youth, disabled, rural communities)			Provide safeguards in place
Community gatekeepers (e.g., elders, leaders) have been consulted and approved the activity			Attach letter(s) of support
No participant will be harmed or put at risk (physically, emotionally, psychologically)
Benefits of the project outweigh potential risks
Participants will receive feedback or benefit from findings

---

4.SayPro Consent Process

• Method of Consent (tick all that apply):
  ☐ Written Consent
  ☐ Verbal Consent
  ☐ Online/Click-through Consent
  ☐ Consent via Guardian (for minors)
• Language(s) used to explain project to participants:
  ________________________________________
• Interpreter/Facilitator Involvement:
  ☐ Yes ☐ No
  If yes, specify role and language:
  ________________________________________

---

5.SayPro Data Handling and Retention

• Type of Data Collected:
  ☐ Audio recordings
  ☐ Video
  ☐ Survey responses
  ☐ Interviews/Focus groups
  ☐ Other: ___________________________
• Data Storage Method:
  ________________________________________
• Retention Period (months/years):
  ________________________________________
• Data Destruction Method (e.g., secure deletion):
  ________________________________________

---

6.SayPro Declarations

I confirm that:

• This project adheres to ethical standards of SayPro and relevant national research guidelines.
• Appropriate consent will be obtained and documented.
• Participants will be treated respectfully and protected from harm.
• Any changes to the research protocol will be submitted for review.

Signature of Researcher/Facilitator:

---

Date:

---

---

7. SayPro Ethics Committee Review

Reviewer Name	Position	Signature	Date

Decision:
☐ Approved
☐ Approved with conditions
☐ Not Approved

Conditions / Feedback (if applicable):
__________________________________________________________

---

Attachments Checklist

☐ Project Proposal
☐ Participant Information Sheet
☐ Consent Form
☐ Risk Assessment
☐ Community Endorsement Letters (if applicable)