Educational Research Informed Consent Form

Title of Research Study

Researcher(s) Information

• Name:
• Affiliation:
• Email:
• Phone:

Invitation & Purpose of the Study

Procedures

Risks and Benefits

Confidentiality

Participation & Withdrawal

Contact for Questions

• Researcher:
• Supervisor:
• Ethics Committee (if applicable):

Consent

I have read and understood the information above. I voluntarily agree to participate in this study.

Participant Name Signature Date