Informed Consent Form (Example)

I, _____________________ understand that I am a

willing participant in any and all psychology class
demonstrations. I understand that Mr. Ronai will not use
deception unless absolutely necessary to demonstrate a
psychological principle. I am confident that she has
assessed any physical or emotional harm that may result
and will not put me at risk. I also understand my right to
access the results once all data has been gathered and her
obligation to debrief me upon completion of the research.
As we are in a group setting, I realize that confidentiality
will be a difficulty, but that Mr. Ronai will not attach my
name to any details of participation outside our classroom.
Finally, if I so choose, I may decline to participate or
withdraw at any time.

________________________ _____________
STUDENT SIGNATURE DATE