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        University of Michigan

      National Center for Postsecondary Improvement

        Project 5.3 on Student Learning and Assessment

Informed Consent Checklist      

These are what should be included in a informed consent form for the respondent to read and sign.

1. A statement of the study’s objectives and methods
2. How it happened that the respondent was chosen
3. What will be asked of the respondent
4. Who will have access to the respondent’s materials
5. A description of reasonably foreseeable risks or discomforts and of reasonably expectable benefits
6. A statement that participation is voluntary and that respondents’ questions will be answered fully
7. What will be published
8. To whom questions should be directed

Example:

This link is a sample informed consent form