Title of the study: …
Name of Principal Investigator Name of Supervisor (if applicable)
Affiliation (Department, Faculty, Institute) Affiliation (Department, Faculty, Institute)
Email address Email address
Telephone number (not required) Telephone number
Invitation to Participate: I am invited to participate in the abovementioned research study
conducted by (names of researchers).
Purpose of the Study: The purpose of the study is to (clearly indicate the aim of the study, its
purpose and objectives, in a language that participants are able to comprehend using a grade 8
Participation: My participation will consist of (description of tasks that participants will have to
perform (e.g., complete online questionnaires, participate in interviews or focus groups, etc.).
During (insert type of tasks), I will be asked (include themes and/or topics that will be covered).
***Be specific (include details: # of sessions/tasks, duration of each session/task, if audio- and/or
video-recording, if participants will be reviewing transcripts, etc.).
*If audio/video-recording or photographs are optional, add a space for participants to
indicate this choice (e.g., check boxes).
Risks: My participation in this study will entail that I (e.g., volunteer personal information, discuss
sensitive topics) and this may cause me to feel (describe potential risks or inconveniences, whether
emotional, psychological, physical, social, economic or other). I have received assurance from the
researchers that every effort will be made to minimize these risks (describe what measures are
taken to minimize such risks – e.g., option to refuse to answer, option to withdraw, identities will
not be revealed, resources will be provided, etc.).
Benefits: My participation in this study will (explain how the participation will benefit the
participant, society and/or how it will contribute to the advancement of knowledge).
Confidentiality and Privacy I have received assurance from the researchers that the information
I will share will remain strictly confidential. I understand that the contents will be used only for
(purposes for which the collected data will be used) and that my identity will be protected (explain
if anonymity will be guaranteed. If anonymity cannot be protected, state this explicitly, explain the
reason why and explain the risks involved for the participant, the organization, etc.; also, explain
whether or not the identity of the participants or their organizations will be revealed in
*If participants are given the option of remaining anonymous or using their real
names/affiliations, add a space for them to indicate this choice (e.g., check boxes).
*If participants take part in a group activity/discussion, add the following sentences (as they
apply to your project): I am aware of the limits to confidentiality of participating in a group
activity. While the researchers will respect the confidentiality of participant data, I understand