Consent Criteria for Surveys




1.     A statement that all participation is voluntary.               


2.     A statement that you are conducting research and the reason for it (e.g., master's thesis, publication, etc.).


3.     Purpose of the research - what you are investigating.


4.     A statement that all responses will be kept anonymous and confidential.


 5.    A statement that participants need not respond to all questions.


6.     If participants are students, a statement that class standing will not be affected in any way based on participation. 


7.     The name and telephone number of the Principal Investigator (PI) and faculty sponsor (if applicable).  







I am conducting a study on  ________________________________.  If you wish to participate in this study, please complete the survey that appears below.  Please do not put your name on this form since all responses will be kept anonymous and confidential. Your participation in this study is voluntary.  You may choose not to respond to any question or to not participate in the study as a whole with no penalty to you.  If you have any questions, my name and contact information appear below:


 (Name and contact information of researcher)