CONSENT FORM FOR CHOMA MARKET SURVEY

 

Dear Participant,

 

We would like to invite you to participate in a market survey conducted by CHOMA and HIVSA aimed at exploring various aspects of your life, including Financial Wellness, Sexual & Reproductive Health, Family Planning, Health & Wellness, and E-Commerce. Your insights will contribute significantly to our understanding of the needs and preferences of our subscribers, helping us tailor our content and services to better meet your requirements.

 

Purpose of the Survey:

The purpose of this survey is to gather information on the following topics:

 

  • Financial Wellness
  • Sexual & Reproductive Health
  • Family Planning
  • Health & Wellness
  • E-Commerce

 

Survey Details:

  1. The survey will be conducted online through a secure platform.
  2. The questions are designed to be non-intrusive and will only ask about your opinions, preferences, and experiences.
  3. Your responses will be kept confidential and anonymous, and your personal information will not be shared with any third parties.
  4. HIVSA is a Responsible Party in terms of the Protection of Personal Information Act 4 of 2103, and has it’s address at Address: 66 Sailor Malan Avenue, Aeroton Soweto
  5. HIVSA will take all prescribed and reasonable precautions to ensure that your information is safeguarded.

 

Participant Responsibilities:

  • Please provide honest and accurate responses to the survey questions
  • If you have any concerns or questions during the survey, feel free to reach out to our support team at info@choma.co.za .

 

Duration:

The survey consists of 6 sections and each section is expected to take approximately 15 minutes to complete.

 

Benefits of Participation:

By participating, you contribute to valuable market research that will help improve the services and content provided by CHOMA and HIVSA.

This is your opportunity to voice your opinions and concerns on topics that directly impact your life.

 

Voluntary Participation:

Your participation in this survey is entirely voluntary. You are free to withdraw from the survey at any point without providing a reason.

 

Confidentiality:

Your responses will be kept confidential, and any information collected will be used for market research purposes only. Your personal information will not be disclosed or sold to any third parties.

 

Consent:

I have read and understood the purpose of the survey, my responsibilities as a participant, the estimated duration, and the voluntary nature of my participation. I understand and agree that the information collected in terms of this questionnaire will solely be used for the stated purpose. I agree to participate in the market survey conducted by CHOMA and HIVSA.

I understand and agree that by signing this consent form, I give my consent to CHOMA and HIVSA to process my information and I am aware that:

  1. I can withdraw this consent at any time.
  2. I have a right to request access to my data at any time, in the prescribed form.
  3. I have a right to request that my data is corrected or updated, in the prescribed form.
  4. I have the right to complain to the information regulator.
  5. The necessary information to assist me in exercising these rights in is HIVSA’s POPI Act Manual, which is available on the HIVSA website.

 

Thank you for your participation.

 

Sincerely, Choma