Journalistic Interview Consent Form
This consent form outlines the terms under which your interview may be conducted and utilized.
Interview Details
Date:
Interviewer's Name:
Interviewee's Name:
Purpose of Interview / Publication Outlet:
Consent Agreement
I understand that this interview may be recorded and used for journalistic purposes.
I grant permission for my responses to be quoted and published.
I understand I may withdraw consent at any point before publication by notifying the interviewer.
I am aware that my interview may be edited for clarity or length while preserving meaning.
Additional Terms or Notes:
Interviewee Signature:
Date:
Interviewer Signature:
Date: