Confidential Interview Record Template
Interview Details
Date
Location
Time
Interviewer Name
Interviewer Role
Participant Information
Name
ID (if applicable)
Contact Details
Relationship to Case/Subject
Interview Notes
Key Topics Covered
Summary of Responses
Interviewer Observations
Actions & Recommendations
Agreed Actions / Follow Up
Recommendations
Confidentiality & Consent
Consent Provided
Confidentiality Notes
Signatures
Interviewer Signature
Participant Signature
Date