Institutional Review Board: Informed Consent

Whenever feasible, researchers should use consent forms when conducting interviews.  Here is an example of what an interview consent form might look like.  Note: Information marked [in italics] is required, but then delete the bracketed material italics when you fill in the content appropriate to your own project.  Adaptation of this template should be discussed with your faculty adviser.   (This template is adapted from a form provided by Malaspina University-College.)

 

• A statement that the study involves research
• An easy to understand explanation of the purpose of the study
• How long it takes to participate
• A simple description of the procedures to be followed
• Identification of any procedures which are experimental
• If deception is involved, there should be an indication that the research cannot be fully described at this time, but that at the end of the subject's participation an explanation will be provided
• A description of any reasonably foreseeable risks or discomforts to the subject.
  • These include not only physical injury, but also possible psychological, social or economic harm, discomfort or inconvenience.
• A description of any benefits to the subject or to others which may reasonably be expected from the research
  • If there is no direct benefit, this should be stated. Please note that payment is not considered a benefit. Indirect benefits (e.g., at the societal level or positive feelings owing to their contribution to research at Bard) should be clearly identified as indirect.
• A statement concerning costs or compensation to the subject, if any.
• Contact information for those who can answer questions about the research and the subject's rights, and (if applicable) for whom to contact in the event of a research-related injury to the subject. For senior projects, normally participants should be invited to contact the principal investigator or faculty advisor if they have any questions about the research, and to contact the chair of the IRB if they have questions about their own rights as research participants.
• Description of the extent, if any, to which confidentiality of records identifying the subject will be maintained
• A statement that participation is voluntary, that neither refusal to participate nor participation discontinued at any time will invoke penalty or loss of benefits to which the subject is otherwise entitled
• Information about access to the results of the research.
• For senior projects, you should disclose that the final project will be permanently and publicly available in the Bard College library and online. In most cases, this disclosure is a courtesy.
• The participant's signature, as well as their printed name and date should appear on the consent form.

Children as Research Participants
This page may be used to augment the Informed Consent page. Please read the Informed Consent page in its entirety before reading the following section.

Though they cannot legally provide informed consent, children (those under 18) should be given an explanation -- at a level appropriate to the child's age, maturity, experience, and condition -- of the procedures to be used, their meaning to the child in terms of discomfort and inconvenience, and the purpose of the research.

Children should be asked if they wish to participate in the research or not. A child must say “yes.” A child’s failure to say “no” does not constitute assent. It must also be made clear to the child that no one will be upset with them if they decline to participate.

In the proposal, the investigator should indicate:

1) how assent will be obtained (what the investigator will say to the child and whether or not the child's parent(s) or guardian(s) will be present);

2) how assent will be documented. The child may either sign a very brief assent form or verbally indicate a willingness to participate.

Remember, even if the child ASSENTS, his or her legal guardian(s) must still CONSENT in order for the child to participate. 

1. if the principal risks are those associated with a breach of confidentiality concerning the subject's participation in the research (e.g., studies on potentially sensitive topics such as illegal drug use, other illegal conduct, or sexual behavior);


2. if the consent document is the only record linking the subject with the research; or


3. if the research presents no more than minimal risk and involves procedures that do not require written consent when they are performed outside of a research setting.

Video Image Release Form for Without Words, a project by Eudora Welty, supervised by Rosalind Franklin.

USAGE:  Without Words is a film and/or video project.  The resulting product will be a film and/or video, Internet web pages, stills for publication, promotional materials, distribution materials, art installation, or other creative work that will be available to the public.

I, the undersigned participant, hereby give Eudora Welty and Rosalind Franklin specific permission to publish, copyright, distribute and/or display images (motion and still) of my likeness created as part of the Without Words project.

By signing below, I acknowledge that 1) I have read this agreement carefully; 2) any questions I have about the use of my image have been answered satisfactorily; 3) any additional assurances or verbal qualifications that have been made to me have been added in writing to this document; 4) I have been given a copy of this form, including any changes or restrictions, initialed by me and by Eudora Welty.

I understand and agree to the conditions outlined in this video image release form.  I hereby allow Eudora Welty and Rosalind Franklin to use this recording, and I give up any and all of my own future claims and rights to the use of this recording.

Participant’s signature:  ______________________________

Date:  _________________

Participant contact information (optional):  ________________________________

Filmmaker’s Contact Info:  Eudora Welty; Bard College, 845.758.xxxx.

Rosalind Franklin, Ph.D., Film Program; Bard College, 845.758.xxxx.