Academic Research Participant Consent Form
Study Title
Researcher(s) Information
Name(s):
Email:
Institution:
Purpose of the Study
Procedures
Potential Risks and Discomforts
Potential Benefits
Confidentiality
Voluntary Participation
Contact Information
Consent Statement
I have read and understood the information above. I voluntarily agree to participate in this research study.
Participant's Name:
Date:
Signature:
Researcher's Name:
Date:
Signature: