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Consent Form Generator


Purpose of the Study:

Example 1: the effect of time of day on reading comprehension.

Example 2: whether people make economic decisions differently when working in a group versus individually.

Example 3: how viewing pictures of natural disasters affects fear of terrorism.


Principal Investigator (PI) Information

   Male   Female 

1 - Do not use home phone or address if at all avoidable.





Consent Form Generator


Doctoral Dissertation   Master's Thesis   Class Project   Faculty-directed Research
Other:


Description of Procedures:

If you agree to be in this study, you will be asked to do the following:


Example 1: Complete a questionnaire about your background (age, gender, education, etc.).

Example 2: Take part in an interview about your responses to two videos showing different hiring techniques for a job as a personnel director.

Example 3: Play three rounds of a computer game that asks you to be an auction buyer in competition with other buyers for a work of art.

If you need more than 5 items, add them manually in your word processing program once the draft has been generated.






Consent Form Generator


Length of Participation (total number & approximate length of sessions)

Example: two hours of your time: 30 minutes to complete the questionnaire and approximately 45 minutes for each of the two interviews. The interviews will be held two weeks apart.

Session Recording (will the subject be audio/video-taped?)

None Audio Video

Example 1: Although every effort will be made to prevent it, you may find the sensitive nature of some of the questions upsetting. In that event, the investigator will provide you with a referral to a counselor with whom you may discuss your feelings.

Example 2: There is a risk that you may have some muscle soreness for about four days.






Consent Form Generator



Methods to Protect Confidentiality:

Example 1: assigning code numbers to each participant so that data is never directly linked to individual identity.

Example 2: keeping all completed forms in a locked cabinet only accessible to the investigator.

Example 3: submitting forms with no identifiers to a sealed drop box so that subjects are anonymous.






Consent Form Generator


Nonparticipation or Withdrawal (only applicable if subjects are student or receive service from a related agency/organization):

Example 1: will not affect your services you receive at NYU.

Example 2: will not affect your grades or academic standing.





Consent Form Generator


Please check the form for accuracy before clicking the download button.

Clicking anywhere in the form will allow you to edit.

Clicking the 'Download Word Document' button will allow you to download the form as a Microsoft Word document to upload to Cayuse.




Consent Form Generator


Designed to help NYU investigators prepare a draft Consent Form for use in an Application for Review to the NYU IRB.

The generator will fill in the Consent Form using NYU IRB standard language and format.

Where appropriate, examples of the types of information needed have been provided.

Language for Parental Permission and Child Assent are different and not provided by the consent form generator.


Please remember to:

  • Write at no higher than a 10th grade level, using language appropriate for the population (e.g., children, those for whom English is a second language, or are expected to be poorly educated, etc.). Avoid technical language or discipline-specific terms.
  • Be consistent about using "you" to refer to the subject. For the investigator, use "the investigator" or "the researcher" to refer to the person carrying out the study. Do not refer to yourself, the investigator, as "I".