Sample Informed Consent Language

Sample Informed Consent Language for Online Surveys

You are invited to participate in a research study about ____________________________.

This study is being conducted by ______________________________ with the assistance of ______________ (Faculty Supervisor) from the Department of ________________________ at Methodist University.   The objective of this study is to ____________________________________________.  

You were selected as a possible participant in this study because you are ____________________________________________________________________________

There are no known risks if you decide to participate in this research study. There are no costs to you for participating in the study. The information you provide will be used in my work __________________________________. The questionnaire will take about _____ minutes of time to complete. The information collected may not benefit you directly, but the information learned in this study should provide more general benefits.

This survey is anonymous / confidential (Need to discuss with supervisor). (If anonymous may add statement.) We will not collect IP addresses and the information is encrypted; however we cannot guarantee absolute anonymity over the internet. No one will be able to identify you or your answers, and no one will know whether or not you participated in the study. If you begin the survey your responses are automatically entered into the database and will be included in our data. Should the data be published, no individual information will be disclosed. Our Institutional Review Board may inspect these records.

Your participation in this study is voluntary. By clicking on this link ___________  and completing the survey, you are voluntarily agreeing to participate. You are free to decline to answer any particular question you do not wish to answer for any reason.

If you have any questions about the study, please contact (Faculty Sponsor) ______________ at (910) ___________ or by e-mail _____________

If you have any questions about your rights as a research participant or if you feel you’ve been placed at risk, you may contact the Methodist University Institutional Review Board (IRB) by mail at Methodist University, Institutional Review Board, by phone at (910) 630-7418, or by e-mail at


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