Research Consent Form

  • by Dr. Cara Zaskow 

    Informed consent should address the following issues:

    • A very general statement about the purpose of the study.
    • A brief description of what the participants will be asked to do.
    • A brief description of the risks, if any, and what the researcher will do to restore the participant.
    • A statement informing participants that they may refuse to participate or withdraw at any time without being penalized.
    • A statement regarding how the participant's confidentiality will be protected
    • Encouragement to ask questions about participation
    • Instructions regarding whom to contact if there are concerns
    • Information regarding where the subjects may be informed about the study's findings.

    Sample Verbal or Written Introduction

    My name is _______ and I am a Psychology student at Capilano University. I am doing a study about ______________ as a course assignment. If you agree to participate, it would involve __________________ (e.g. filling out a questionnaire, etc.) that would take about ____ minutes of your time. There are no risks associated with the study. You are under no requirement to participate in this study and should feel free to decline. Even if you decide to participate, you may withdraw from the study at any  time. You will not be penalized for not participating or for withdrawing. No information that identifies you personally will be collected. Your participation will be anonymous and all information will be kept confidential. The _____ (scores or questionnaires, etc.) will be shredded by the instructor at the end of the study to ensure the confidentiality of your responses. If you have any questions or concerns about the study, please contact the course instructor, Dr. ________________, email address:  ________________. If you are interested in the findings of this study, please feel free to  _____________  (e.g. attend the poster/power point presentation or contact the researcher).

    Sample Signed Consent Form (if a signature is required)

    I agree to take part in this study, which has been explained to me. I have been given an opportunity to ask questions about the study. I understand that any questions I answer will be anonymous, and that my identity will not be disclosed at any point. I also understand that my participation is completely voluntary, and I may withdraw from the study at any time. I am 18 years old or over, and am legally able to provide consent.
    __________________________ _________________
    signature of participant & date