Sample Information Release Form (Consent Form)

© Copyright Carter McNamara, MBA, PhD, Authenticity Consulting, LLC.


Description

Whenever an evaluator, or researcher, is focusing and reporting on personal information about a research subject, he or she should obtain permission from the subject to do so. The following form can be used as a sample. The final version of the form depends on the nature of the evaluation or research.

Sample Form

I voluntarily agree to participate in the evaluation of the ABC program. I understand that this evaluation is being conducted by Carter McNamara, the Program Director, to improve the ABC program and is also the basis of his doctoral dissertation.
I understand that the evaluation methods which may involve me are:

1. the Program Director's recorded observations of my circle and its process and/or

2. my completion of evaluation questionnaire(s) and/or

3. my participation in a 30-60 minute interview.

I grant permission for the interview to be tape recorded and transcribed, and to be used only by Carter McNamara for analysis of interview data. I grant permission for the evaluation data generated from the above methods to be published in an evaluation report to the funder, The McKnight Foundation, and in the dissertation and future publication(s).

I understand that any identifiable information in regard to my name and/or agency name may be listed only in the above-mentioned evaluation report to the funder, that is, this information will not be listed in the dissertation or any future publication(s).



_______________________________________
Research Participant

_______________________________________
Date


Submit a link


For the Category of Evaluations (Many Kinds):

To round out your knowledge of this Library topic, you may want to review some related topics, available from the link below. Each of the related topics includes free, online resources.

Also, scan the Recommended Books listed below. They have been selected for their relevance and highly practical nature.

Related Library Topics

Recommended Books


Find a Topic
* Free Trainings
Learn Consulting
Learn Strategic Planning

 

 


Free Management Library, © Copyright Authenticity Consulting, LLC ® ; All rights reserved
Website developed by NilesRiver.com         Graphics by Wylde Hare Creative
Provided by

Authenticity Consulting, LLC
Contact Info Legal Privacy