Consent Form for CSE340
Contact information for person running study: [Fill in]
Introduction and Purpose of study (Beneficence)
[Fill in: Write 1-2 sentences about what this study is about]
Requirements for participation (Respect for Persons)
To participate in this study you must be [Fill in: Requirements (only age: must be 18 or older)]
Study procedures (Respect for Persons)
You will complete a series of menu selections during this study. You will need to click on 108 menus to complete the session as mentioned above. You should expect this to take approximately [Fill in: X Minutes]
[Fill in: Tell the participant if they will be compensated or not]
Voluntary nature of Study (Respect for Persons)
Your participation is voluntary and you can stop at any time without penalty. Your decision not to participate will not have an impact on [Fill in: What might be coercive to the participant]
Benefits of Study (Beneficence)
This study will not directly benefit you. However, it will help us to understand [Fill in]
Privacy and Data Collection (Respect for Persons)
Your responses will be kept anonymous. We do not store any information that could be used to directly establish your identity.
Contact (of IRB typically; Me in this case)
If you have any concerns about this study, you can reach out to the Professor in charge, Lauren Bricker, bricker [at] uw.edu
Written Consent
Please answer the following questions
The application programmer described the purpose of the study to me, and explained that my participation in this study is voluntary Yes [ ] No [ ]
I am 18 or older Yes [ ] No [ ]
I am willing to participate in this research Yes [ ] No [ ]
To protect your privacy, we are not collecting your signature. However instead please write the words “I Consent” and draw a picture of a sun next to those words.