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Sample Consent Form

This document is a sample consent form for a psychological research study, outlining the necessary information participants must understand before agreeing to participate. It emphasizes the confidentiality of data, the voluntary nature of participation, and the age requirement for consent. Participants must sign to indicate their understanding and agreement to the terms of the study, with provisions for parental consent if under 16 years old.

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0% found this document useful (0 votes)
11 views4 pages

Sample Consent Form

This document is a sample consent form for a psychological research study, outlining the necessary information participants must understand before agreeing to participate. It emphasizes the confidentiality of data, the voluntary nature of participation, and the age requirement for consent. Participants must sign to indicate their understanding and agreement to the terms of the study, with provisions for parental consent if under 16 years old.

Uploaded by

jefferson
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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SAMPLE CONSENT FORM

Study Title:

Experimenter(s): (provide the full name of at least


one of the people responsible for running your
study)

Description of Experiment: (provide a sentence or


two about the general activities participants will do)

In order to participate in this research study, it is


necessary that you give your informed consent. By
signing this informed consent statement you are
indicating that you understand the nature of the
research study and your role in that research and
that you agree to participate in the research. Please
consider the following points before signing:

I understand that I am participating in psychological


research;

I understand that my identity will not be linked with


my data, and that all information I provide will
remain confidential;

I understand that I will be provided with an


explanation of the research in which I participated.

I understand that certain facts about the study


might be withheld from me, and the researchers
might not, initially, tell me the true or full purpose of
the study. However, the complete facts and true
purpose of the study will be revealed to me at the
completion of the study session.

I understand that participation in research is not


required, is voluntary, and that, after any individual
research project has begun, I may refuse to
participate further without penalty.

By signing this form I am stating that I am 16 years


of age or older, and that I understand the above
information and consent to participate in this study
being conducted at the [Insert School]. If I am not
16 years of age or older I must have a parent
signature in order to participate.
Name (printed)
_________________________________________
____________________________________

Signature:
_________________________________________
______________ Date ________________

Parent Name (printed)


_________________________________________
________________________

Parent Signature
_________________________________________
__________Date_________________

*You may also want to include the time and


place where the experiment will take place.
*Include any other information about your
target population which can be collected at this
time, for example:
 Gender
 Age
 IB Classes enrolled in at the current time
 Bilingual students
 Full IB students

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