Informed Consent

SAMPLE

Hartwick College Department of Psychology
Informed Consent for Participants


PLEASE READ THIS DOCUMENT CAREFULLY. SIGN YOUR NAME BELOW ONLY IF YOU AGREE TO PARTICIPATE AND YOU FULLY UNDERSTAND YOUR RIGHTS. YOUR SIGNATURE IS REQUIRED FOR PARTICIPATION. The policy of the Department of Psychology is that all research participation in the Department is voluntary, and you have the right to withdraw at any time, without prejudice, should you object to the nature of the research. Your responses are confidential. Any report of the data collected will be in summary form, without identifying individuals. You are entitled to ask questions and to receive an explanation after your participation. If you have concerns about your participation in this study, you may contact:

Researcher:   Joe Student           Phone: 5555

Supervising Investigator:  Prof. Jane Doe                   Phone:  5551

Purpose of the Study: We are investigating the many factors that may influence individual judgment in a courtroom situation.

Description of Participant Tasks:    You will be asked to read summaries of defense and prosecution arguments in a realistic criminal case.  You will then be asked to rate the probability that the defendant in the case is guilty of the crime charged, and whether or not you would vote “guilty’ or “not guilty”. You will also be asked questions about the basis for your decision, and will be asked some personal information.

Estimated Duration: Approximately 20 minutes

Compensation: You will receive 2 experimental credits towards your research-participation requirement in your introductory psychology course.

Possible Risks: When filling out the questions, you may come across a question or answer choice that you find unpleasant, upsetting, or otherwise objectionable.  Also, you will be asked to provide anonymous and confidential information about yourself that you may find intrusive.

Possible Benefits:  When your participation is complete, you will be given an opportunity to learn about this research, which may be useful to you in your course or in understanding yourself and others.

Confidentiality:  You will be assigned a code number which will protect your identity. All data will be kept in secured files, in accord with the standards of the American Psychological Association. All identifying information will be removed from questionnaires as soon as your participation is complete. No one will be able to know which responses are yours. Finally, remember that it is no individual person's responses that interest us; we are studying the usefulness of the tests in question for people in general. Results from this study may be published or presented, but no data will be presented with identifying information.

Opportunities to Question:  When your participation is complete, you will be fully debriefed regarding the design of the experiment, the hypotheses, and the predicted results.  You will receive feedback regarding your individual performance and will have the opportunity to ask the researcher questions.

Opportunities to Withdraw at will:  If you decide at any point to withdraw this consent or stop participating, you are free to do so at no penalty to yourself -- you will still be fully compensated for your participation.. You are free to skip specific questions and continue participating at no penalty.

I state that I am over 18 years of age or have parental consent to participate, have read the statements above, understand the same, and voluntarily sign this form.

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Participant Signature                                                                                  Date