Sample Informed Consent Form for Subjects Under Age 18 Years

Sample Informed Consent Form for Subjects Under Age 18 Years Date

Potential Study Participant:

Name of Study Participant

Name of Parent(s)or Legal Guardian(s) Address City, State, Zip Code

Phone Number

Dear Study Participant and Parent or Guardian:

Identification:

As part of my work toward a bachelor’s degree in the Department of Sociology at University of NC at Wilmington, I am conducting a study of _________ for _______.

Purpose:

The purpose of this study is to gain an understanding of __________ (be general, not specific, use clear language that non-sociologists will understand).

Protection of Privacy:

Confidentiality of you as the study participant and your responses will be protected throughout the study. State how it will be protected: You will lock all study files in a filing cabinet. All computer files will be password protected. Only the research team will have access to the files. Study participant’s names will not appear on any study documents with the exception of this form.

Voluntary Participation:

Following parental or legal guardian consent, your participation in this study remains voluntary and you can refrain from answering any or all questions without penalty or explanation. Please note that your responses are appreciated and will add to the validity of the study. 
Your participation will involve (list all that apply, such as completing a survey, possibly being interviewed in person, or participating in a focus group). Identify how long it will take for the study participant to complete each of the above.

Contact:

If you have any questions or comments concerning this study, you or your parent(s) or legal guardian can contact me at my office (phone number) or that of my faculty advisor, Dr. Jammie Price (910-962-3590). This survey was approved by The Institutional Review Board for The Protection of Human Subjects at The University of NC at Wilmington. Questions or comments can also be directed to the Institutional Review Board via Attention Dr. Candace Candace Gauthier (910-962-3558), Office of Philosophy and Religion.

Thank you for your assistance.

Sincerely,