Verbal Script for Letter of Information and Consent Form
(Sample Format for Interview)
“Title of Study”
P.I. (Hi, my name is ____). I am a researcher from ___Queen’s University. I am
conducting a research study called [title]. The goal of my research is to ____________[1
or 2 sentences]. It will take about __ minutes of your time to complete this interview.
Are you interested in learning more about participating in my study?
Participant: No/Yes.
NO = Is it that you don’t have the time right now? Can we meet [I can call you
at or we can meet face-to-face to discuss …at] another time? No/Okay,
thank you for your time. Have a good day.
YES = Okay, thank you. Is this a good time to conduct the interview?
P.I.: Good. Before I ask you any questions, I would first like to provide you with some
information about my research project and about your rights as a participant. Feel free
to ask me any questions that you might have about my research project.
Because this is a research project, it was first cleared by my Research Ethics Board and it
complies with Canadian ethical principles and Queen’s research policies.
It might interest you to learn that your participation in my research will help me learn
about [explain what you are hoping to learn from your study and how your study will
advance scientific knowledge]
For my research project what I am asking participants to do is [e.g., Answer questions?
Look at pictures? Etc...) You do not need to [do or answer] anything that makes you feel
uncomfortable. You can provide me with answers such as “I don’t know”, “I can’t
remember”, or “I don’t want to answer”. That’s okay. You can also stop this interview at
any time by just telling me to do so. If you want to quit, then I will ____ [explain
terminating interview process, for example, destroy interview data] what you have said
so far. Is this okay?
Because I don’t want to miss anything that you are saying, do you agree to allow me to
record our interview with my use of [notebook, recording devices, etc.]? YES/NO
I am now recording our conversation. If you don’t want me to record some parts of your
answer just tell me to stop recording and I will stop the [recording device] and then I will
start it when you are ready to have me to do so. Does that sound all right with you?
Participant: YES/NO.
P.I.: This information is standard for all participants in research but it is important that
you understand that your participation is completely voluntary and that you are
informed about everything that might affect your decision to choose to participate in
my research. For example, you should know that [“There are no known risks associated
with being involved as a participant in my research”] or [“There are some risks that we
want you to be aware of before you agree to participate in my research.”] They are [for
example social, psychological, economic, physical and explain them] ________. To
minimize any risks to you, I will [for example, not quote you or I will only be reporting
the information you give me in aggregate form – and explain what aggregate form
means]. Are you worried about any of these risks? (TALK about them). Do you still want
to participate in my research?
Participant: YES/NO/Unsure.
P.I.: (Address any concerns.)
To protect your privacy I would like to ___ [use a codename, pseudonym, collect the
information anonymously and will only use it in an aggregate form – explain]. By doing
this ___(above)___ I will do my very best to protect your privacy and confidentiality. The
information I am collecting right now is called the raw data. In order to ensure your
privacy and confidentiality I will remove any personal information that might identify
you from the raw data. This cleaned version or de-identified version is my scientific
data. Do you understand what I mean? YES or NO.
Only myself and my supervisor [explain who will have access to the raw data and why
this is necessary] will be aware of who said what and we will not reveal this information
to anyone [unless there are applicable laws, in which case explain your duty to report].
The raw data, which includes your personal information or information that can identify
you [provide examples, mailing address, postal code, identifiable physical features,
health information, etc.], will be stored in a [e.g., locked room, on a password protect
computer, in an encrypted electronic file]. The scientific data (i.e., the information that
doesn’t include your personal information) will be made public in scientific publications,
conferences, etc… I might also share the scientific data with other researchers but they
will never have access to the raw data.
If, however, [you want me to quote you] or [I would like to quote you] do you agree to
my quoting you and citing you by name? Yes/No.
Any personal information that I have collected about you I will [destroy in, for example,
5 years after I have published all of my research findings] or [I would like to hold on to it
indefinitely in case I want to contact you in the future]. ****Explain to the participant
what you would like to do with the data and see if that is okay.
Example – Do you mind if I hold onto all of the data, including data that includes your
personal information, indefinitely? YES/NO. Depending on response: Can I contact you
in the future? YES/NO
P.I.: (Address any concerns.) As a thank you for your time, I will give you _____(only use
this statement if there is compensation/reimbursement for out of pocket expenses)
__________. (Other information as needed).
Participant: No/Yes.
P.I. Great. Before we begin I want you to know that I have also written this information
down, we call it a Letter of Information. The Letter of Information will remind you of my
project and commitments I have made to you. It also has contact information if you
have any concerns about your rights as a participant or concerns about how I conducted
this interview, etc… You should keep it somewhere safe should you have need of it in
the future.
Do you feel ready to start the interview or do you have any other questions?
Participant: YES/NO.
P.I: I will begin this tape recorded interview by stating the date ___ and thanking my
guest (code number, pseudonym, name) for allowing me to interview him/her about
___________. Please remember that we can turn off the tape recorder at any time or
erase some information or say “off the record”. Are you okay to begin?
Participant: Yes/ No
P.I.: Okay- let’s start. My first question is …..” Complete interview.
P.I. That is the end of the interview. Please keep this letter of information and please
let me or others know if you later have any concerns. Give compensation (if applicable).
Do you have any further questions of me?
Thank you for your time.