Survey Consent Form

Information you will need

• What’s the title of the study?
• What’s the researcher’s name?
• What's their institution?
• Why is the individual selected to participate?
• What’s the purpose of the study?
• What type of questions will be asked?
• How long will the survey take to complete?
• What compensation will the participant receive?
• Who can the participant contact if they have questions?
• What’s the phone number of the contact person?
• What’s the email address of the contact person?
• What’s the participant’s full name?

The form includes 1 signature line.