(Section 50.25)

In seeking informed consent, the following information shall be provided to each subject:

1. A statement that the study involves research, an explanation of the purposes of the research, the expected duration of the subject’s participation, a description of the procedures to be followed, and identification of any procedures which are experimental (e.g., the use of human subjects for the study of new drugs, devices, or procedures).

2. A description of any reasonably foreseeable risks or discomforts to the subject.

3. A description of any benefits to the subjects or to others that may reasonably be expected from the research.

4. A statement describing how anonymity or confidentiality of records will be maintained.

5. For research involving more than minimal risk, an explanation as to whether any compensation and/or medical treatments are available if injury occurs and, if so, what they consist of, or where further information may be obtained.

6. Who to contact for answers to pertinent questions about the research and who to contact in the event of a research related injury to the subject.

7. A statement that participation is voluntary, and that refusal to participate or discontinuation of participation will involve no penalty or loss of benefits to which the subject is otherwise entitled.

8. Assent from minors: When minors serve as research participants, consent should be obtained from the parent and assent obtained from the minor. A minor’s choice to participate in human subjects research is called “assent” because individuals under 18 years of age cannot legally give consent. Please click on the sample assent form link for an assent form template that can be used as is, or customized according to the child’s age or the research design.

Below are sample informed consent forms (adult and minor):

Consent form template for adult participants (18 years and older)

(Broad Title of Research Project)

I consent to serve as a participant in the research investigation entitled (title of project) being conducted by (name of researcher/s) as part of (a senior research project/a class project/a research project) for (name of class or department) at Monmouth College.

I understand that this study is investigating (include a brief description of the study topic). As a participant in this study, I will be asked to (describe all of the tasks that participants in the study will complete). This study will last approximately (include a high estimate of how long your study will take).

I understand that the potential benefits of this study to participants are (describe the potential benefits of participating in your study here, including any compensation for participation). The potential risks to participants in this study are (describe any risks here). I understand that the information that I provide is confidential and my identity will not be revealed (You may wish to alter this sentence if your study is anonymous because you are not collecting any identifying information from participants. If not anonymous, you may want to address confidentiality issues by describing who will have access to the data).

I understand that my participation is voluntary and that I am free to withdraw consent and to discontinue participation in the project at any time without penalty. If I have any questions about the project, either before it begins or after I have participated, I may ask the researcher directly (or contact the researcher’s advisor) using the contact information below. I am at least 18 years old.

On the basis of the above statements, I agree to participate in this project.

Participant’s Signature:
Participant's Name (printed):
Date:

Researcher’s Name:
Researcher’s Email Address:
Researcher’s Phone number:

Faculty Advisor’s Name:
Faculty Advisor’s Email Address:
Faculty Advisor’s Phone number:

Consent form template for parental consent for participants who are under 18 years old*

(Broad Title of Research Project)

I give consent for my child to serve as a participant in the research investigation entitled (title) being conducted by (name of researcher) as part of (a senior research project/a class project/a research project) for (name of class or department) at Monmouth College.

I understand that this study is investigating (include a brief description of the study topic). As a participant in this study, my child will be asked to (describe all of the tasks that minor participants in the study will complete). This study will last approximately (include a high estimate of how long your study will take).  

I understand that the potential benefits of this study to participants are (describe the potential benefits of participating in your study here, including any compensation for participation). The potential risks to participants in this study are (describe any risks here). I understand that the information that my child provides is confidential and the identity of my child will not be revealed (You may wish to alter this sentence if your study is anonymous because you are not collecting any identifying information from participants. If not anonymous, you may want to address confidentiality issues by describing who will have access to the data).

I understand that my child’s participation is voluntary and that I am free to withdraw consent and to discontinue my child’s participation in the project at any time. If I have any questions about the project, either before it begins or after my child has participated, I may ask the researcher directly (or contact the researcher’s advisor) using the contact information below.

On the basis of the above statements, I agree to allow my child to participate in this project.

Parent, Guardian, or Teacher’s Signature:
Parent, Guardian, or Teacher’s Signature (printed):
Date:

Researcher’s Name:
Researcher’s Email Address:
Researcher’s Phone number:

Faculty Advisor’s Name:
Faculty Advisor’s Email Address:
Faculty Advisor’s Phone number:

*This form may also be used, with modifications, for adults unable to provide their own informed consent.

Go to The Online Submission Form