Participant Information and Consent Form — Template

Last updated: 2026-09-20

Authored by Souvik Mandal, Ph.D.

Project Leader & Instructor, Computational Behavioral Sciences, LS100, FAS, Harvard University | LinkedIn ID: souvik-mandal-phd

Before you use this template¶

What this template does not cover¶

Anyone under 18. This template is written for adults who can consent for themselves. Recording a child requires permission from a parent or guardian and age-appropriate assent from the child, on different forms. It is also a regulatory dead end: the exemption that otherwise covers identifiable recording of public behaviour, 45 CFR 46.104(d)(2)(iii), explicitly may not be applied to research involving children. If your project involves minors, talk to the instructor and CUHS before you plan anything else.

Anyone who is not comfortable in English. Consent must be given in a language the participant genuinely understands, and translated consent documents carry their own requirements. Do not translate this yourself or work through a friend of the participant. Contact the instructor and CUHS first.

Anyone who cannot consent for themselves, for any reason. Same instruction: ask first.

If your project needs any of these, that is not a reason to abandon the question — it is a reason to start the conversation early, because the approvals take longer.

The pathway you actually have to follow¶

Harvard’s position on course projects is narrower than students usually assume, so read this carefully.

A class project run purely to teach research methods does not require the course instructor to file an IRB application. Harvard states that directly on Undergraduate Research and Course Projects: “It is no longer necessary for the Course Instructor to submit an IRB application when the purpose of the class is for educational purposes only.”

That is not the same as “nothing is required.” On the same page, Harvard is explicit that all undergraduate research starts with the Undergraduate Research Training Program (URTP), and that “whether or not your undergraduate research project requires IRB review, ethics training is a required part of the URTP.”

So your sequence is:

1. Start at the URTP Portal. Identify a Research Supervisor and complete the required ethics training (IRB-led or CITI).

2. Complete the URTP Decision Form. It is reviewed by an IRB regulatory expert — this is how it gets decided whether your specific project needs IRB review, and it is not a formality you self-assess.

3. Do not self-certify as “exempt.” CUHS is unambiguous in its FAQs: “The regulatory category of ‘exempt’ research must be reviewed by CUHS prior to being carried out. Whether your study is exempt is a determination made by the designated CUHS staff person who reviews your application.”

4. If review is needed, submissions go through ESTR at irb.harvard.edu and require an HUID. An undergraduate may be listed as PI, but only with a PI-eligible faculty sponsor also listed.

5. Only then start recording. If the initial intent is for the data to be used beyond the classroom, Harvard puts the responsibility on the faculty advisor to resolve this before the project begins.

How to fill it in¶

Replace every placeholder. Keep the language plain — the federal requirement at 45 CFR 46.116 is that consent begins with “a concise and focused presentation of the key information” in language the participant can understand, and contains no exculpatory language (nothing asking them to waive rights). Short sentences beat formal ones.

Print two copies: the participant keeps one, you keep one. Give them time to read it and ask questions before anyone signs.

The next two pages are the participant’s. This page is for you — do not hand it over.

Part 1 · Participant Information Sheet¶

Study: [PLAIN-LANGUAGE TITLE]

Researcher: [YOUR NAME], Email: [YOUR EMAIL]

Supervisor: [INSTRUCTOR NAME], Email: [INSTRUCTOR EMAIL] LS100, Harvard University (FAS)

The short version. You are invited to take part in a student research project. Taking part means [YOU WILL BE VIDEO / AUDIO / VIDEO AND AUDIO RECORDED] while you [DO THE ACTIVITY], and takes about [N] minutes at [LOCATION]. It is entirely voluntary: you can say no, and you can stop at any point, without a reason and without consequence. The main thing to weigh is that a recording of you is identifiable — your face [AND/OR] voice can be recognised. What happens to it is below, and you control part of that overleaf.

Why this is being done, and why you. [ONE OR TWO PLAIN SENTENCES ON WHAT YOU WANT TO FIND OUT AND WHY IT MATTERS. NO JARGON.] This is a course project run for teaching purposes. [IF RESULTS MIGHT BE USED BEYOND THE CLASSROOM, SAY SO PLAINLY.] You are being asked because [REASON]; about [N] people will take part.

What you will be asked to do. [STEP ONE]; [STEP TWO]; [STEP THREE], recorded using [EQUIPMENT]. You need not do anything you are uncomfortable with, and can ask for the recording to be paused or stopped at any time.

What happens to the recording. Software extracts [WHAT YOU MEASURE], so what gets analysed is a table of numbers rather than the recording itself. Only [YOUR NAME] and the supervising instructor can see the original, unless you agree otherwise overleaf. It is kept on [SPECIFIC APPROVED STORAGE — not "my laptop"] with access restricted by [HOW], and deleted at the end of the semester plus [30 / 60] days after final grades — by [DATE] at the latest. The extracted numbers [WILL / WILL NOT] be kept after that. Your name never appears in any report: recordings carry a code, and the code-to-name list is stored separately and destroyed on the same schedule.

Risks, benefits, one honest limit. No physical risk beyond what you would normally experience while [ACTIVITY]. [ADD ANY STUDY-SPECIFIC RISK, OR: "We are not asking you anything personal."] The real risk is loss of privacy: if a clip of you is shown — only if you agree overleaf — people who know you may recognise you. Masking the eyes is not reliable anonymisation. There is no direct benefit to you. [STATE COMPENSATION, OR: "You will not be paid."]

Changing your mind, and who to contact. To withdraw, contact the researcher above at any time; your recording and everything derived from it will be deleted. After [DATE OR MILESTONE] data cannot be removed from a completed analysis, though the recording can still be destroyed. For questions about your rights as a participant: Committee on the Use of Human Subjects, Harvard — cuhs@harvard.edu, 617-496-2847.

Part 2 · Consent and Signature¶

Study: [PLAIN-LANGUAGE TITLE]

Researcher: [YOUR NAME]

Instructor: [INSTRUCTOR NAME]

Required to take part — please write your initials beside each statement.

Optional — you can take part without agreeing to any of these. A blank box means no, and nothing changes about your participation.

Signatures. The researcher signs to confirm they explained the study, gave the Information Sheet, answered questions, and that consent was given freely.

Sign two copies. The participant keeps one; the researcher keeps the other, stored separately from the recordings.