This form is designed to obtain fully informed consent from children, youth (and their families), and adults who are being asked to participate in a Personal Outcome Measures® (POM) interview.

It should be used anytime someone is asked to participate in a POM interview, for any reason. This includes activities connected to CQL Accreditation, Training, Certification, or Consultation. Regardless of whether there is a legally authorized representative or not, the child, youth, (and their families) or adult will be asked if they agree to the interview, through the use of the Consent Form.

‘Easy Read’ Approaches

The POM Consent Form and Companion Guide use content that is typically included in standard consent forms, but clarifies them through the use of some of the concepts of the ‘Easy Read’ approach.

  • Write concretely, avoid abstract language
  • Be logical
  • Avoid jargon
  • Be concise and summarize
  • Break information into small chunks
  • Leave out what is of little or no use
  • Avoid difficult words
  • Include contact phone number
  • Make sure any pictures are related to the text
  • Test the material
  • Type with at least 14pt sized text
  • Use a font similar to Arial
  • Avoid writing in capitals
  • Yellow backgrounds can be helpful for people with dyslexia
  • Leave ample white space
  • Avoid acronyms or abbreviations

Formulario de Consentimiento de POM y Guía de Acompañamiento

Este formulario está diseñado para obtener el consentimiento plenamente informado de niños, jóvenes (y sus familias) y adultos a quienes se les pida que participen en una entrevista de Personal Outcome Measures® (POM).

Debe usarse cada vez que se le pida a alguien que participe en una entrevista POM, por cualquier motivo. Incluye actividades relacionadas con la acreditación, capacitación, certificación o consulta del Consejo de Calidad y Liderazgo (Council on Quality and Leadership, CQL). Independientemente de si hay un representante legalmente autorizado o no, se le preguntará al niño, joven (y sus familias) o adulto si están de acuerdo con la entrevista, mediante el uso del formulario de consentimiento.