Informed Consent Form [ Must be on Dal Letterhead ]
CS 4163 (Summer 2002) Prototype Evaluation Study
| Principal Investigators: |
| [ Name of a group member ] |
| [ Name of another group member ] |
| [ Name of yet another group member ] |
| [ Name of one more group member ] |
| Faculty of Computer Science |
| Dalhousie University |
We invite you to take part in a research study at Dalhousie University. Taking part in this study is voluntary and you may withdraw from the study at anytime. There will be no repercussion from choosing not to participate in this study. The study is described below. This description tells you what you will be asked to do and includes any risks or inconvenience you might experience.
Participating in the study may not benefit you directly but we might learn things about the design of interfaces for [ describe activity, e.g. reading articles from computer screens, taking notes ] that will benefit others. The risks from participating in this experiment are minimal. There is no compensation for participating in this study and you may terminate your participation in the study at any time without prejudice. You should discuss any questions you have about this study with either of the principal investigators or with the people administering the study.
The purpose of this study is to evaluate how [ list the appropriate features ] of a computer-based program can help people who [ describe anticipated user population, e.g. scholars and researchers ] to [ describe activities, e.g. take notes while reading ] .
The study consists of a single session in which you will be asked to complete some [ insert task description ] tasks using a computer program or simulated computer program and [ filling out a short questionnaire when you are finished, or whatever ] .
All personal and identifying data will be kept confidential. No personal identifiable information will be used in the study results. All results will be identified by a code which cannot be used to identify you. This informed consent form will be kept in a secure location under confidentiality for one year after the end of this school term.
If you have any difficulties with, or wish to voice concern about, any aspect of your participation in this study, you may contact the Human Research Ethics/Integrity Coordinator at the Dalhousie University Office of Human Research Ethics and Integrity for assistance. The phone number is (902)494-1462.
`I have read the explanation about this study. I have been given the opportunity to discuss it and my questions have been answered to my satisfaction. I hereby consent to take part in the study. However, I realize that my participation is voluntary and that I am free to withdraw from the study at any time.'
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