NYU
NYU HRPP (Human Research Protections Program)
Consent Form Generator







ELIGIBILITY TO PARTICIPATE


This section is optional, unless the inclusion/exclusion criteria relate to subject safety (i.e. avoiding enrollment of those for whom participation may be risky or unsafe), important as a measure to prevent unintentional enrollment of vulnerable subjects (such as those under 18), or necessary for the scientific conduct of the study (e.g., study requires participants fit certain criteria, such as recruiting a specific clinical population).

Be sure to inform people if screening procedures may result in participants being excluded from continuing with the study.







DESCRIPTION OF STUDY PROCEDURES


Explain ALL procedures that subjects will be asked to take part in during the research, where these procedures may take place (e.g. study clinic, classroom, via zoom, etc.), and the expected time duration for each procedure. Further formatting and editing will likely be needed in the document you download. See additional directions below.


Use layperson’s terminology; avoid scientific or research jargon and acronyms.

Avoid using technical wording copied/pasted directly from the IRB application or grant proposals.

The description should be clear and easy to follow. The use of bullet points, tables, section headings, numbered steps, etc., is encouraged if it helps with readability.

For surveys, interviews, focus groups, include a description of the types/nature of questions subjects will be asked or the topics to be addressed.

If groups of participants may complete different procedures and the procedures will be assigned/determined after obtaining consent, then describe each of the procedures that participants may complete and the mechanism for determining which they will complete (e.g., randomization).

If participants or their actions will be recorded (audio, video, screen capture, etc.) this must be described, including whether participants are required to allow the recording in order to participate or whether the recording is optional.

Including photographs of equipment to be used or other visual aids to help promote understanding is encouraged.

If applicable, describe procedures that may occur over multiple days/sessions.

Include all active and passive study procedures, including requesting consent to access records or to collect information about them from a third-party. If the study involves the ongoing, passive collection of data (e.g., via browser plug-ins), then describe the procedures for subjects to stop the researchers from collecting this information, e.g., uninstalling plug-in, contacting the researchers.

E.g., “If you agree to participate, you will be asked to complete a survey that should take approximately 30 minutes. The survey will ask demographic questions (e.g., age, gender) and about your feelings regarding riding the subway.”






RISKS OR DISCOMFORTS


List all reasonably foreseeable physical, informational, emotional, psychological, legal, and privacy concerns, and, if applicable, the degree and likelihood of each. Use numbering or points to separate each type of risk


Risks or discomforts vary greatly by study procedures, and include, but are not limited to such things as:

  • embarrassment or emotional discomfort from answering sensitive questions during a survey or interview;
  • harm from a loss of confidentiality;
  • motion sickness/simulator sickness;
  • muscle or joint pain/soreness from exercise;
  • pain, bruising, light-headedness and possible infection from a blood draw;
  • allergic or other reactions caused by stimuli or devices (e.g., headaches, seizures, etc.);
  • skin irritation from application of sensors or wearing activity trackers.

Risks or discomforts should be clearly outlined, using layperson’s terminology.

When applicable, include any measures to mitigate the risk/discomfort.

If there are no foreseeable risks/discomforts, please inform participants accordingly. Note that there’s a risk of a breach of confidentiality any time personally identifiable information is linked to study data.

BENEFITS


Describe how the information gained in this study will help society, advance knowledge, etc.


If there are reasonably foreseeable direct benefits to participants, then describe them. (Leave blank otherwise)

Participants often do not directly benefit from participation in research.

The description of benefits should include the degree and likelihood of the benefits and may not be overstated.

Do not list compensation as a benefit (see compensation section).







COMPENSATION




If Yes, please describe (see directions below): 


If a person is to receive money or another token of appreciation for their participation, explain when it will be given and any conditions of full or partial payment (e.g., “If you decide to not continue your participation in the study, you will be compensated $5 for each visit”). Include whether participants will receive payment if they withdraw early or skip any questions/procedures (e.g., “You may skip any questions and still receive full compensation” or “You must answer all questions in the survey to receive compensation”).

Include accurate, detailed information about the compensation. For instance, if a gift card or non-cash payment will be used, then provide details about it, e.g., $10 Amazon gift card.

Include statement if participants will be reimbursed for any study related expenses, such as travel.

If a raffle/drawing may be used, then include the likelihood of winning, e.g., “You will have a 1 in 10 chance of receiving compensation from the drawing.”

If “attention checks” or similar criteria will be used to determine compensation, then acknowledge it here, e.g., “The survey includes questions to ensure participants are answering questions accurately. If you do not answer these questions correctly then you may not receive payment.”

Please review the NYU Research Expenditures Involving Participant Support Costs and Human Subject Payments (FAQs) for additional conditions and requirements.


VOLUNTARY PARTICIPATION

If applicable to your study, complete the following (DO NOT include if they’re not applicable):


Describe early withdrawal procedures:

'If you withdraw from the study early, '


'We may end your participation in the study if '

Describe any other implications of withdrawing from the study below, such as not receiving compensation.







PRIVACY & DATA CONFIDENTIALITY


Please select the most appropriate choice from the following:
  1.  No identifiable information will be linked with the research data
  2.  Identifiable information will be recorded/linked with research data AND all participants’ identities will remain confidential
  3.  Identifiable information will be recorded/linked with research data AND participants’ will be asked if they wish for their identities to remain confidential. (Signed consent should be used to document participants’ agreement to not remain confidential).
  4.  Identifiable information will be recorded/linked with research data AND participants’ identities will not remain confidential. (Signed consent should be used to document participants’ agreement to not remain confidential).

Future Use of Data (choose one):
  1.  Study data, even if de-identified, will be used only for this study and will not be used for future research, shared with other researchers, or placed in a data repository. (This option should be used in very rare circumstances. In general, researchers are expected to make de-identified data available to others or for future research or to at least ask participants if they are willing to share their data, even if the researchers have no current intent to do so)
  2.  Study data may be used for future research, shared with other researchers, or placed in a data repository and participants must agree to this in order to participate in the study. (Note that this is the most common option used for most research studies).
     Check if applicable: Only de-identified data will be shared.
    (Do not use this option for studies in which participants may directly benefit from the research. Participants that do not wish for their data to be shared or used for future research must be allowed to participate in a study that involves the possibility of direct benefits)
  3.  Study data may be used for future research, shared with other researchers, or placed in a data repository and participants will be able to agree or disagree to this, but they won’t be able to agree to whether the data will be de-identified or not. Select this option if you intend to only share de-identified data.
     Check if applicable: Only de-identified data will be shared.
    We will not ask for your additional permission before sharing this information. Participants will be able to choose to give permission.
  4.  Study data may be used for future research, shared with other researchers, or placed in a data repository and participants will be able to agree or disagree to this and to whether the data shared will be identifiable or not.

Notes:

Describe the extent to which confidentiality of information identifying the participants will be maintained (e.g., completely confidential, not confidential, not confidential if the participant chooses)

Avoid overly specific plans for keeping data confidential that may need to be modified in the future, such as plans to store data in specific locations or that access to data will be limited to certain individuals (i.e., do not say that only the researchers will have access, as the IRB or study sponsor may require access). It’s most important to describe the extent of confidentiality, rather than the mechanisms/procedures for keeping data secure.

Unless you are absolutely certain that you wish to do so, DO NOT specify any plans to destroy data. Destruction of identifiers is typically sufficient to ensure confidentiality; retaining the de-identified data is usually acceptable (and often preferable). Destruction of the actual data may be appropriate in highly unusual situations where the data cannot be de-identified and retention presents unreasonable risk to subjects. Data retention should comply with NYU’s Retention of and Access to Research Data Policy.

If applicable, include conditions in which the researchers may not maintain confidentiality/privacy, such as instances in which laws require mandated reporting.


ACCESS TO YOUR STUDY INFORMATION

Generally, if identifiable information is not collected, then participants will not be given access to information collected about them.

If participants will be given access, then describe how this will occur, e.g., by requesting directly from the study team, the investigator will share information with participants if there is a concern, participants can access their information at all times via study applications, etc.

If the data collected may relate to diagnostic criteria or be a part of a formal assessment (e.g., Montreal Cognitive Assessment), then this should be acknowledged and it should state whether these assessments can be used for formal diagnostic or assessment purposes.






CONTACT INFORMATION


Researcher or research group’s name.



For a student project, the faculty sponsor’s or research group’s name and contact information MUST be included below.


AGREEMENT TO PARTICIPATE


 Signed consent 
 Written consent without signature 
 verbal consent without a signature 






SUMMARY OF THE RESEARCH STUDY


This consent form is longer than 3000 words.

Therefore, this section must include a concise and focused presentation of the key information most likely to help your prospective participants understand the reasons they may or may not want to participate (e.g., brief description of the study procedures, risks, and benefits). This information MUST be organized and presented in a manner that facilitates understanding. Some of the information may be copied from other sections of the consent form.



Purpose of the Study (brief):

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.

Description of Procedures (brief):

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

(briefly describe procedures in an easy to understand, numbered format)

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.

Benefits & Risks (brief)

Are there more than minimal risks, i.e., beyond those of everyday life?  






Form Review and Download


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.
Once you have downloaded, proofread, and revised the Microsoft Word document you must save it as a PDF before attaching it to your IRB application.

Be sure to check your consent form for:

  • Spelling, typographical, and grammatical errors.
  • Use of language understandable to the targeted population of research participants. Avoid jargon, technical language, acronyms or discipline-specific terms.
  • Formatting/organization that facilitates understanding, e.g, sections clearly separated, single-spaced, 11 or 12-point type, 1 inch margins.
  • All applicable sections are complete and template formatting is removed (colored text, brackets, etc.).
  • Information matches what is described in the IRB protocol (e.g., compensation amount described in protocol matches consent form).




This Consent Form Generator is designed to help NYU investigators prepare a draft consent form for their NYU Cayuse HE (Human Ethics) applications.


The generator will create the consent form according to the HRPP consent form template. It is not intended to be used with studies evaluating the safety or effectiveness of an intervention or treatment (e.g., clinical trials, RCTs).


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:

  • Use of language understandable to the targeted population of research participants. Avoid jargon, technical language, acronyms or discipline-specific terms.
  • Check that what is described in the IRB protocol matches the information in the consent form (e.g., compensation amount described in protocol matches consent form).