Informed Consent (Example)

I understand that my participation in this research project is voluntary and that I may withdraw from the study at any time without penalty.  I also understand that the data will be anonymously coded to endure confidentiality.  The purpose of this study is… (Input information here. If you are deceiving your subjects do not disclose the actual purpose).

As a participant in this study I will (describe what the subject will be doing). The questionnaires will not include my name or any other identifying information and will be (stored or destroyed).

(Relate the level of risk here).  I understand that this research presents no risks other than what I might feel from thinking about the questions presented to me.  

The project has been explained to me and I have a satisfactory understanding of what will be asked of me by participating.  Any further questions about the research and my rights as a participant can be answered by contacting (contact information).

I understand that Central Christian College of Kansas is not responsible for any injuries I may suffer during the time I am a research participant, unless those injuries are due to Central Christian College of Kansas.  I may address questions and complaints to Professor Lenny Favara, Central Christian College of Kansas at 620-241-0723.

I have read the material above and I agree to participate in this activity. All questions have been satisfactorily answered.

I have received a copy of this consent form.

________________________________Signature    ________________________________Date