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User Consent

Consent Form Templates

USING CONSENT FORM TEMPLATES

Identify your interview and research audience

Select a consent form that works best for your purposes

Create a word document or form to request consent from participants, copy-paste the content from coda to your desired format.

Consent Form (for minors)

I agree to allow my child/ward to participate in the [nature of] study conducted by [Agency/Organization].

I understand that participation in this [nature of] study is voluntary, and I agree to immediately raise any concerns or areas of discomfort my child/ward or I might have with the study administrator.

Please sign below to indicate that you have read and you understand the information on this form and that any questions you might have about the session have been answered.

Date:_________

Child’s name: ________________________________________________

Please print your name: ____________________________________________________

Please sign your name: ____________________________________________________

Thank you!

We appreciate your participation.

General Consent Form

Hello! We are doing a [nature of] study as part of our [project title] with [agency/org/department]. The purpose of this study is to understand [insert purpose]

We would like to interview you as part of our research efforts, and will be focusing on the following themes:

You’ll be asked to share your experience with [insert the service or process you’re trying to understand]. We’ll ask you specifically about [insert activity examples or other specific thing that the person should know ahead of the session]

What might you need to participate?

We’ll need [time]

You’ll need a laptop with internet access.

These are casual chats and there’s no need to prepare in advance

How will we use the data?

The record of your participation in this research study will be kept confidential.

Any recordings will be deleted once our research is complete.

Anonymized quotes may be used in reports, talks, or presentations.

What are your rights as a participant?

Your participation in this study is voluntary.

You can take a break or stop the session at any time.

You can ask us to stop recording at any time.

You can ask us not to use any or all of your responses, even after we are done.

Please sign below to indicate that you have read and you understand the information on this form and that any questions you might have about the session have been answered.

Date:_________

Please print your name: ____________________________________________________

Please sign your name: ____________________________________________________

Thank you!

We appreciate your participation.

Statement of Consent (for verbal consent)

Thank you for taking the time to join us today for this interview/session. My name is ________, and I am joined by my colleagues _____________ and ___________, who will be taking notes. Before we begin, we'd like your verbal consent to record this conversation in video and/or transcription format. During today's discussion, we will ask you questions about your thoughts and observations about [topic]. The intent is to get broad perspectives and experiences from the Montgomery County community — that includes residents, youth, community service providers, and support stakeholders — to inform Montgomery County Government strategy and work to make our community a thriving and safe place for everyone. There are no right or wrong answers to any questions, so please feel free to be candid.

All of us agree not to disclose any of the information you share. Any data that we want to share publicly will be anonymized, and no names will not be disclosed. You have the right to stop the interview anytime. The interview is entirely consensual. You also have the right to request the deletion of any data collected during this interview, even after it ends. This interview will take from [time] as requested.

Please verbally consent by stating, "I agree to being recorded during this interview," to begin today's conversation.

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REFERE

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REFERENCES

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Interim AP 6-1 Use of County-Provided Technology (1).pdf

1.1 MB

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RELEASE.docx

86.5 kB

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