Millikin University Irb Consent Form Instructions (Page 4 of 7) in pdf

Sample Forms

Sample 1

UNIVERSITY OF WISCONSIN-MADISON

Research Participant Information and Consent Form

Title of the Study: Communication about money allocation decisions

Principal Investigator: XXXXXXXX (phone: (XXX) XXX-XXXX or (email: x@wisc.edu)

Student Researcher: XXXXXXXX (phone: (XXX) XXX-XXXX or (email: s@wisc.edu)

DESCRIPTION OF THE RESEARCH

You are invited to participate in a research study about how people communicate about

money allocation decisions.

You have been asked to participate because you are taking a Communication Arts or

Journalism class that offers extra credit for participation in this study.

The purpose of the research is to examine how people both communicate about the

allocation of money and perceive an interaction with another person in which they discuss

the allocation of money. The research will examine differences in communication when

people deceive versus do not deceive.

This study will include undergraduates taking Journalism and Communication Arts classes.

Research will be conducted in the Communication Science lab in 4000V Vilas Hall.

Video tapes will be made of your participation. Research personnel will view the

videotapes. The tapes will be kept until the research is published in a scientific journal;

once the research has been published, the tapes will be destroyed.

WHAT WILL MY PARTICIPATION INVOLVE?

If you decide to participate in this research you will be asked to either allocate a small

amount of money between yourself and your partner (role of allocator) or receive an

allocation of money from your partner (role of recipient). You will discuss the allocation of

money face-to-face with your partner for a few minutes. This interaction will be videotaped.

After the interaction, the recipient will make a decision whether or not to accept the money

from the allocator. The recipient will not be told the amount of money given to the allocator.

Afterwards, you will be asked to fill out a questionnaire about the interaction.

You will be asked to complete two interactions with two different partners.

Your total participation will require approximately 25 minutes.

ARE THERE ANY RISKS TO ME?

We don't anticipate any risks to you from participation in this study.

IRB Consent Form Guidelines

2/13/2015

Millikin University Irb Consent Form Instructions Page 4