Survey Informed Consent

Survey Informed Consent

Title of Research Study: {Title}

You have been invited to participate in a study conducted by researcher {Name} of {name of college or other institution}. By participating, you affirm that you are at least 18 years of age, and are participating voluntarily.

PURPOSE OF SURVEY

The purpose of this study is {purpose}.

YOUR INVOLVEMENT

You may be asked to {action such as complete survey, read article, disclose information about yourself and your beliefs, etc.} There {are/are no} right or wrong answers. We anticipate that your participation in this survey will take {number} minutes.

COMPENSATION

Once you have completed the survey, you will receive a payment of {amount} via {method}.

CONFIDENTIALITY

No identifiable information about you will be disclosed. After data collection, {storage or disposal procedures}. Your records are confidential to the extent permitted by law. Your data may be accessed by {institution or researchers}. Studies like this are monitored by {oversight ethics entity} to ensure that your rights as a participant are protected.

CONTACT

Please address any questions or concerns about the study to Principal Investigator: {Name, title, and contact information}. For any concerns about your rights as a survey/study participant, contact: {Institutional Review Board contact information}.

By completing this survey, you are agreeing to participate in the study and have your answers counted anonymously among the results.

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