Sample Consent Form Format
(The purpose of this template is to streamline the IRB approval process by assisting investigators in remembering to include all required elements of informed consent.)
Invitation to Participate in Research Project
Welcome potential participants; note any requirements for inclusion in the sample (age, class membership, etc.) specify that the endeavor is research and that participation is voluntary.
Purposes, Procedures, and Duration of the Study
Describe, to the extent possible, the purposes of the study.
Describe, to the extent possible, the procedures that will be used. (Avoid disciplinary jargon; phrase these sections in plain English.)
Give a reasonable estimate of the time involved to complete the study. (If it’s a SOTL study, the time involved is not the semester, but any time required of students to complete research-specific duties like filling out surveys. Do not include time necessary to complete assignments (or even surveys) that are required of all students as part of the course.)
Possible Benefits and Risks of Participation
How, if at all, will this study benefit the participants? If not of immediate benefit to the participants, how might it be expected to benefit future generations? (If it’s SOTL research, do not include potential benefits of the class – but only of participation in the research component.)
If any incentives (money, food, etc.) are offered to potential participants, describe these.
If participants are offered access to the study’s results, specify where, when, how, and from whom these are to be obtained.
Risks may include anxiety about performance, giving answers that may threaten the way participants are viewed by the investigator, threats to self-esteem, etc. even if the project poses no physical and/or medical risks. (In SOTL research, a major hurdle is that students may feel they cannot say “no” to the research component without potential damage to their grade and/or their relationship with the professor. Special protections apply to situations where the researcher is in an authority relationship with the potential participants – whether as their instructor, a family member, or a supervisor.)
Your Options Regarding Participation and Continuation
Non-participants must be clear that this choice will not result in penalty (e.g., poorer grades) or loss of benefits (e.g., extra credit opportunities) to which they would otherwise be entitled.
Be explicit in stating that persons who choose to participate may change their minds (withdraw from the study) without being hassled in any manner about this choice.
If the research involves students and will take place during class sessions, specify
what non-participants will do during the research project (be dismissed early, etc.)
Confidentiality and Disclosure of Responses
Responses are only anonymous if names or other potential identifiers (demographic information, etc.) are not retained in any form.
If any identifying information is retained, the best you can promise is confidentiality. You should specify where the data will be kept and who (# of persons and their statuses) will have access to the data, where it will be reported (conferences, journals, etc.) and in what format (group responses? Quotes from individuals? A combination thereof?)
Are you recording the participants in any manner (audio and/or video)? If so, confidentiality is more likely to be compromised. Who will have access to these recordings? Where will they be stored? For how long? When and how will they be destroyed?
Whom to contact
Add the contact information for the IRB Coordinator here, noting that participants should contact this person if any research-related problems arise and/or if they have questions about the rights of subjects in research.
Decision about Participation
If participation is being solicited in a group setting, having both participants and non-participants sign somewhere maintains the privacy of each person’s choice. If data are intended to be anonymous, a consent script (and a request to waive documentation of consent) is preferable to a signed document. Each individual should receive a copy of the consent form/script so that they have the necessary contact information, should questions arise at a later date.
If minors (including students under the age of 18) are to be included, the consent form must also state that consent of a parent is also required before participation may begin, and a space should be allocated for parental signature.
I have read this consent form and voluntarily (check one):
AgreeDo NOT AgreeNot Eli Eligible (under 18)
to participate. I understand that I am not required to participate and that, even if I agree to be take part, I may freely withdraw at any time prior to <date> with no consequence to my grade or reputation. My signature also indicates that I have received a copy of this consent form.
______
Participant’s signatureDatePrint name here