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Participant Consent Form Template

This participant consent form outlines the key information for a research study, including confirming the participant has read and understands the study information, that their participation is voluntary and they can withdraw at any time, and that they agree to take part. It also includes optional statements for consent to audio/video recording and quoting with a pseudonym. The participant and researcher sign and date the form, with one copy for each kept on file.

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Kelly Alevra
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145 views1 page

Participant Consent Form Template

This participant consent form outlines the key information for a research study, including confirming the participant has read and understands the study information, that their participation is voluntary and they can withdraw at any time, and that they agree to take part. It also includes optional statements for consent to audio/video recording and quoting with a pseudonym. The participant and researcher sign and date the form, with one copy for each kept on file.

Uploaded by

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

(Form to be on headed paper)

PARTICIPANT CONSENT FORM


Participant name:
Title of Project:
Name of Researcher:
___________________________________________________________________

Participant to complete this section: Please initial each box.

1. I confirm that I have read and understand the information sheet for the
above study. I have had the opportunity to consider the information, ask
questions and have had these answered satisfactorily.

2. I understand that my participation is voluntary and that I am free to


withdraw at any time, without giving any reason.

1. I agree to take part in the above study.

The following statements could also be included on the consent form if


appropriate:

2. I agree to the interview / focus group / consultation being audio recorded

3. I agree to the interview / focus group / consultation being video recorded

4. I give permission for my words to be quoted (by use of pseudonym)

_______________________________________ ___________________
Signature of Participant
Date
_______________________________________ ___________________

Name of person taking consent Date

____________________________________

Signature of person taking consent

* When completed, 1 copy for participant & 1 copy for researcher site file

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