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Informed Consent Form – Instructions and Template
Informed consent documentation is required whenever there are human participants involved in research.
The following sections are required in all informed consent documents, and this instructions sheet is
intended to assist students in the preparation of informed consent documentation. The Office of the Dean,
Graduate Studies has created a template which is attached to these instructions, and which students are
encouraged to utilize. Wherever necessary, informed consent documents should be modified based on the
research being conducted. Informed consent documentation should be developed in conjunction with the
research ethics protocol (York University Graduate Student Human Participants Research Protocol).
Study name:
Include the study name.
Researchers:
Include the names of all researchers here (student(s) and faculty).
Include your level of study, graduate program and institution.
Include your contact details, including email address and/or office phone number. Do not use a personal
phone number or home address.
Purpose of the research:
Include a statement about the purpose of the research. Include a statement indicating how the research will
be conducted, presented and reported.
What you will be asked to do in the research:
Include a statement regarding the role and/or responsibilities of the research participants. Include a
statement regarding the estimated time commitment for the participation. If inducements will be offered,
indicate them here.
Risks and discomforts:
Include a statement regarding any real or perceived risks or potential discomfort that may result from
participation in the research. If there is a possibility of harm or discomfort it must be described and the
mitigation methods must be indicated.
Benefits of the research and benefits to you:
Include a statement regarding any benefits of the research as well as benefits to the research participants.
Voluntary participation:
Include the following required text: “Your participation in the research is completely voluntary and that
participants may choose to stop participating at any time. Indicate that a participant’s decision not to
continue participating will not influence their relationship or the nature of their relationship with researchers
or with staff of York University either now or in the future.”
Withdrawal from the study:
Include the following required text: “You may stop participating in the study at any time, for any reason, if
you so decide. Your decision to stop participating, or to refuse to answer particular questions, will not affect
your relationship with the researchers, York University, or any other group associated with this project. In
the event that you withdraw from the study, all associated data collected will be immediately destroyed
wherever possible.”
If you are offering inducements, the following text is also required: “If you decide to stop participating, you
will still be eligible to receive the promised pay for agreeing to be in the project“.
Confidentiality: