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Consent Form Sample #3 Online Research

Perceptions of Post-Traumatic Stress Disorder

You are invited to participate in a research study on perceptions of post-traumatic stress disorder (PTSD). This study is conducted by Dr. Rachel Wells, Associate Professor of Psychology at Iona College.

This study will take approximately 45 minutes of your time. You will be asked to complete an online survey about your perceptions of PTSD, attitudes, and some demographic information (such as age and gender).

Your decision to participate or decline participation in this study is completely voluntary and you have the right to terminate your participation at any time without penalty. You may skip any questions you do not wish to answer. If you do not wish to complete this survey just close your browser.

Your participation in this research will be confidential as data will be averaged and reported in aggregate. Your confidentiality will be maintained to the degree permitted by the technology used. No guarantees can be made regarding interception of data sent via the Internet by any third parties. See the following link for more information: Once you complete and submit the survey, we will be unable to extract anonymous data from the database should you wish it withdrawn. If you are not comfortable filling out an online survey, please contact for a paper version.

Possible outlets of dissemination may be professional conferences and refereed journals. Although your participation in this research may not benefit you personally, it will help us understand perceptions and attitudes regarding PTSD.

Your participation in this online survey involves risks similar to a person’s everyday use of the Internet. There are no additional risks to individuals participating in this survey beyond those that exist in daily life.

If you have questions about this project, please contact:
Dr. Rachel Wells
(914) 633-0000

If you have questions about your rights as a participant or any concerns or complaints, please contact:
Dr. Michael Jordan
Provost's Office
Telephone: 914-633-2602

Please print a copy of this consent form for your records, if you so desire.

Your decision to participate, decline, or withdraw from participation will have no effect on your current status or future relations with Iona College.

By clicking the submit button to enter the survey, you acknowledge that you have read and understand the above consent form, that you are 18 years old or older, and indicate your willingness to voluntarily take part in the study.