Standard consent form

You are being asked to volunteer for participation in a research project. Before
giving your consent, it is important that you read the following information and ask all
questions you need answered to be sure you understand what you will be asked to do.
Investigator
My name is John Doe. I am a student in Senior Research Seminar (PSY 460) of the Psychology Department at St. Joseph’s College. My faculty advisor is Dr. Smith. If you have any questions or concerns about this research, she can be contacted in person at Room 000 in O’Connor Hall, by phone at 000-0000, or by email at jsmith@sjcny.edu.
Purpose of the Research
This research is designed to investigate some personality traits of students taking psychology courses. It also will partially satisfy the requirements of my research seminar and give me added experience in conducting research.
Procedures
If you volunteer, you will be asked to report some demographic information and complete
two paper-and-pencil measures of personality that should take about 20 minutes to finish.  In addition, you can read a summary of the results of this research which will be posted after May 30, 20XX at the link for Senior Thesis Projects located in the St.
Joseph’s Psychology Department website.
Potential Risks or Discomfort
Based on their use in past research, there are no foreseeable risks or discomfort expected with these procedures.
Potential Benefits of the Research
For participants, I expect direct benefits will be limited to some experience with the research process. Participation also will satisfy the research experience requirement in Introduction to Psychology (PSY 100).
Confidentiality and Data Storage
As your individual responses will not be associated with your identity in any way, they
will be completely anonymous. The data collected will be stored in Dr. Smith’s office for
three years. Access to individual responses will be limited to college and/or public officials
presenting legal authority for such access.
Participation and Withdrawal
You may refuse to participate in this research without penalty. If you choose to participate,
you are free to withdraw at any time without penalty. To withdraw, simply indicate your
desire to do so. I will collect the measures given to you and destroy them. However, since
individual responses are anonymous, your completed data cannot be withdrawn from the
study after it has been collected.
Ethical Review
The ethics of this research project were reviewed and approved by the Institutional
Review Board (IRB) of St. Joseph’s College. If you believe there has been any infringement of your rights as a research subject, you should contact the IRB chairperson, Name, email and phone number.
Participant Agreement
I have read the information provided above. My signature below indicates my voluntary consent to participate in this research. (Please return one copy of the consent form and keep one copy for your records).
___________________________ _________
Participant’s Signature

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