10 Consent Form

Note: Usage of this consent form is not necessarily appropriate in all contexts and situations and my vary by culture. Use your own best judgement, knowledge, and experience about what is the most appropriate and ethical way to gain consent from the person you are speaking with. The main goals of consent are that: 1) the person understands that you may or may not be doing an audio recording, or taking notes during the conversation; 2) how you plan to use the information the person shares; and 3) if the person wishes to be identified, and if so, how, as well as if they wish to remain unidentified/anonymous. It is also a good idea to make sure the person has your contact information or a way to get in touch with you if they have any questions post-interview. 

PDF version of consent form available here: Interview Consent Form (September 2019)

INTERVIEW CONSENT FORM

My name is ________________________________________ and I am a student at the University of Washington.  I am participating in a course where we are studying international human rights and justice. Students in the class are given the option of interviewing people that have personal experience related to their research topics as a part of our learning experience.

Your name and other identifying information will be kept confidential—only my professor and I will know it. You may hear in advance the list of questions I will ask you, and you may choose not to answer any question you wish.  I would like to record the interview because it is easier to follow your story and get it down right if I don’t have to take notes and ask questions at the same time. However, if you prefer, I will not record. Do I have your permission to proceed?

Yes, you may proceed and record the interview__________________

No, you may not record the interview__________________________

If you agree to this interview, please fill out this form so that I may provide verifying information to the professor who is teaching the class.

Respondent’s Name_____________________________________

Email Address _______________________________________

If you need more information about this project, you may contact my instructor, Emily Willard at the Henry M. Jackson School of International Studies, University of Washington. You can reach her at [phone number] and eawill@uw.edu.

Thank you very much for agreeing to participate!