Please note before moving ahead to register or provide your survivor statement,

Tseshaht First Nation must obtain your Informed Consent.

AIRS Informed Consent Form

To hear the audio of the AIRS Informed Consent Form written below, please click the audio play. 

Purpose

The purpose of this session is to determine the potential locations of unmarked graves/burials/cemeteries and to create a list of names of students who attended AIRS for the possibility of creating a memorial commemoration.

The main data collection method will be research of archives, and other suppositories as well as in-person, over the phone, and other on-line methods with a semi-structured interview, conducted by a member of the AIRS research team. Your participation in this session is voluntary and you are free to end the session at any time. At the conclusion of this project there will be a final report created based on the findings of this research.

You may be asked to provide basic background information (age, gender, years attended Residential School, etc.). Considering the sensitivity of the questions that may be asked, you may be reminded of negative experiences related to Residential School. For this reason, you may request that a support person of your choosing be present with you during this session. We will provide you with information on how to contact counselors, Elders, and other community supports. Counselors will be available at each site during the interview.

Cultural Protocols

Tseshaht will establish and follow cultural protocols for the sacred undertaking of researching and any work related to the search for unmarked graves/burial/cemeteries associated with Alberni Indian Residential School.

Tseshaht will provide cultural supports at any interview to support the individual being interviewed.

Tseshaht will shake the hand of every person interviewed and provide a token of their appreciation

Confidentiality and Data Collection

The interview is entirely confidential. We will use a code number to track each interview. Your name will only appear on this informed consent form, which will be separated from the interview data including Media, Photo, Media Audio and Media Video and it will be kept in a separate and secured file by the research investigators until all files are destroyed.

We will not share your identity with anyone and the project/final report will in no way identify you as a participant in the study. All project documents will be held securely until the project is complete, at which point they will be kept securely within Tseshaht First Nation administration electronic storage/server/data storage through a historical archive.

Limits to Confidentiality

  1. Danger to self: If you pose a danger to yourself, the interviewer will disclose information about you and your condition as necessary to authorities in order to prevent you from harming yourself. Only information relevant to the purpose of keeping you safe will be disclosed.
  2. Danger to others: If you pose a danger to others, the interviewer is ethically bound to protect anyone to whom you present a clear and imminent danger. If you make specific threats of violence against an identifiable person, the interviewer will attempt to protect the potential victim by making an effort to warn them by contacting the police.
  3. Child Abuse: the interviewer is required to report to authorities any suspected case in which a child may be being abused. It does not matter how much time has elapsed since the occurrence of the abuse; if the victim is still a child, the interviewer must report the incident. If I you are an adult and disclose past child abuse, and the interviewer has reason to believe that the abuser is still victimizing children, the interviewer is obligated to report that suspicion.
  4.  Court Orders: the interviewer/Tseshaht First Nation can be ordered to present their notes to the court. the interviewer/ Tseshaht First Nation will comply with a court request or order for notes only after attempting to protect the privacy of your information.

Your signature below confirms your understanding of the above items and your consent to be interviewed. 

Print Name

___________________________

Signature

____________________________

Date

_____________________________

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