Example – Consent for recording, confidential
Recording Consent Form
SNC IRB file #: 060706sc
SNC IRB approval date: June 1, 2007
The Acquaintance Process
Type of Recording
A video and audio recording will be made of each research session.
Purpose of Recording
Observing and taking notes on behavior as it happens is difficult and prone to error. Video and
audio recordings can be slowed, paused, replayed and evaluated by multiple researchers. This
allows researchers to gather more accurate data.
Confidentiality
The recordings will be kept confidential. Information that could identify you will be kept separate
from the recordings. Recordings will be stored securely and only researchers will have access to
the recordings. The recordings will be destroyed (shredded) once the research is completed.
Permission
I, the undersigned participant, hereby give Chris Smith specific permission to make a video and
audio recording of my research session.
Statement of Consent:
I have read the above information. I have asked the questions I want to ask and those questions
have been answered to my satisfaction. I understand and agree to the conditions outlined in this
recording consent form.
_____________________________
Name of Participant (please print)
_____________________________
Signature of Participant
______________
Date
_____________________________
Signature of Researcher
Chris Smith, Psychology Discipline, St. Norbert College, De Pere, WI 54115
(920) 403 – 4115, chris.smith@snc.edu
______________
Date