Consent to Audio Record Interview

• Consent to Audio / Video Record Interview

• Client / Site

• Conducted on

  Date

• Interview Conducted by

• Location
  Address

• Personnel being Interviewed

• Reason for Interview

Personnel Details

• Person Interviewed

• Contact Details of Person Interviewed

• Position of Person Interviewed

• Home store of person interviewed

• Location of interview conducted

• Interview conducted by

• Name of Management witness

• Date Interview Conducted

Consent to Audio / Video

• Do you provide your consent for me (Garry Longthorne), of Keypoint Security Solutions Ltd, acting on behalf of Office Holdings Ltd, to audio record this interview today.

  YES

  NO

• Signature of person consenting to Audio recording of interview

  Sign

Conditions of Interview Explained

• Do you understand this is a formal investigatory interview and that the audio recordings may be used in any subsequent investigatory; disciplinary or appeal hearings.

  YES

  NO

• Have you been told that you can call an adjournment at any time, That you are free to leave the room at any time and that you do not have to answer any questions if you choose not to.

  YES

  NO

• Have you also been told not to answer any questions if you do not fully understand them and that you should ask for clarification before making any answers if you are unsure.

  YES

  NO

• I fully understand the conditions as outlined above & these have been explained to me

  Sign

Right to representation

• Do you want a colleague to act as a witness for you during this interview

  YES

  NO

• Can you confirm that you have been informed of your right to have a witness present.<br>

  YES

  NO

• Name of Witness if requested

• Signature of Staff member being interviewed

  Sign

• Signature of witness (if applicable)

  Sign