This consent form should be:

Written in plain, clear language avoiding the use of jargon and acronyms.

Tailored to the reading level of the participants so they can understand what is required of them and make an informed decision about their participation.

Presented on this template.

This template demonstrates the minimum information that should be included in a consent form for a study exclusively involving an anonymous, online survey. Additional information may be required depending on the nature and complexity of the project.

There are other templates for informed consent for other types of studies.

The template begins on the next page.

Do not include this instruction page with your form.

Directions for what to include in each section are written in italicized red text.

All italicized red text should be replaced with information specific to your project.

[Title of Study]

ONLINE PARTICIPANT CONSENT FORM (for anonymous survey-based research only)

Principal Researcher:	Supervisor: (if applicable)

[insert name and contact info]	[insert name and contact info]

You are invited to participate in a research study about [briefly describe the study in lay terms 1 – 2 sentences]. I am conducting this study as a requirement to complete my [state the degree].

As a participant, you are asked to participate in this study by completing a short online questionnaire about [state the topic or nature of the questions that will be posed]. Participation will take approximately [state the expected duration] of your time.

[Describe the risks and benefits of participation in the research study]. Involvement in this study is entirely voluntary and you may refuse to answer any questions or to share information that you are not comfortable with. You will not be asked to provide any personal or identifiable information or data.

You may withdraw from the study at any time by simply closing out of your browser. Once you submit your completed survey, however, data cannot be withdrawn as the survey is completely anonymous. Please retain a copy of this consent form for your records.

Your data is being collected anonymously and cannot be attributed back to you.

[Note that online surveys (Qualtrix, Survey Monkey etc.) may allow researchers to capture and access additional information about each respondent over and above what they provide in the online survey. In addition, when researchers use the internet to transmit or receive participant data, they should be aware that while in transmission, data may be subject to access by third parties as a result of various security legislation now in place in many countries Therefore, when a researcher is using one of these online survey systems the following statement should be added to the consent form:]

The researcher(s) acknowledge that the host of the online survey (e.g., Qualtrix, Survey Monkey etc.) may automatically collect participant data without their knowledge (i.e., IP addresses.) Although this information may be provided or made accessible to the researcher(s), it will not be used or saved without participant’s consent on the researcher(s) system. Further, because this project employs e-based collection techniques, data may be subject to access by third parties as a result of various security legislation now in place in many countries and thus the confidentiality and privacy of data cannot be guaranteed during web-based transmission.

All electronic data will be kept in a password protected computer at my office [and encrypted, etc.]. All information and records will be destroyed by confidential shredding; electronic records will be deleted, following the obligatory retention period [approximately by xx month, xx year].

Results of this study may be [describe how and where results of the research study will be disseminated and whether or how they will be made available to interested participants. If you are an AU graduate program student and the research is a final research project or thesis, include the following statement: The existence of the research will be listed in an abstract posted online at the Athabasca University Library’s Digital Thesis and Project Room and the final research paper will be publicly available.].

If you have any questions about this study or require further information, please contact [principal researcher] or [supervisor, if applicable.] using the contact information above.

This study has been reviewed by the Athabasca University Research Ethics Board. Should you have any comments or concerns about your treatment as a participant, the research, or ethical review processes, please contact the Research Ethics Officer by e-mail to rebsec@athabascau.ca.

Thank you for your assistance in this project.

CONSENT:

The completion of the [questionnaire / survey] and its submission is viewed as your consent to participate.

BEGIN THE SURVEY

[GUIDANCE NOTE - CONSENT FOR FUTURE SHARING AND/OR REUSE: If you want to store the data you are collecting for future sharing and reuse, you need to include a separate consent statement so that participants can participate in the study but still choose not to have you share their data (see TCPS 2 (2022) article 3.13). How you do this will depend on the survey delivery method you use and whether or not you are using implied consent or a consent form built into your survey. If you are using implied consent (assumed when participants complete the survey), you might include a checkbox or an additional question in the survey. For example:

“Thank-you for participating in this study. We would like to be able to store your responses to [use in future similar research] OR [share with researchers doing similar research in the future]. We will only do so with your consent. If you agree with us storing your responses [for use in our future research] OR [and sharing them with future researchers], please read the following statement and select "yes."

I understand my responses are being collected anonymously. I agree to having the responses I provide [stored by members of the research team] OR [deposited in a research data repository] (if repository is known, add its name and a link here) so they can be accessed for future research studies on related topics. I understand that because my responses are anonymous, I will not be recontacted regarding future uses of the information I provide.

-yes

-no]”