Interview Consent Forms

Consent Form Example for Research: A Fully Completed Sample

A blank template shows you what to ask. This consent form example for research shows what a good answer actually looks like: a university researcher, Priya, interviewing an independent café owner, Marcus, for a study on post-pandemic high streets.

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Written by Mudit AgarwalFounder & Publisher · Digital marketing expert with 8 years' experienceLast updated:

Independently researched and cross-checked against the official primary sources cited on this page. Not written or reviewed by a licensed attorney or clinician.

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1

Review the guidance

Read what this consent form must cover before you fill it in.

2

Preview the template

See every field, checkbox and signature block laid out in full.

3

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On this page

The download below is the completed form itself, with every field written out. The sections after it explain why each entry was worded the way it was, and where interviewers most often get the wording wrong.

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Filled-In Interview Consent Form Sample — fully formatted and ready to print or edit. No signup, no email required.

Why the purpose line is written that way

Notice the purpose field names both outputs: the article and the report. If Priya uses the interview in a conference talk not mentioned, she has gone beyond the agreement.

Naming every output at the time of consent avoids problems. It gives Marcus a real basis for deciding whether to take part. If you are drafting your own, check how to write an interview consent form.

Why attribution and withdrawal deadlines matter

Marcus agreed to be identified by his first name and his business. This is a middle option between anonymity and full attribution. It is common in local research to make the piece feel real.

The form gives a specific withdrawal date. A vague 'any time' would be dishonest because removing a quote after typesetting is not realistic. This specificity is as important as it is in medical consent forms.

Providing a clear date tied to a production milestone is honest. It ensures the participant knows exactly how long they have to change their mind before the work is published.

Storage and access considerations

Access is limited to two named people. This makes the commitment checkable. If a participant asks who has heard their recording, a vague team reference is much harder to answer honestly.

Retention is tied to university policy rather than a guess, much like a participant consent form or a simple interview consent form would handle basic data. The destruction method is also explicitly stated for clarity.

  • Access is limited to two named people — Priya and her supervisor
  • Retention is tied to a university policy figure (five years)
  • Destruction gives both a method and a date

Common mistakes when filling in a form

Writing 'confidential' without saying what that means is a frequent error. Ticking the recording box but forgetting the transcription box also causes confusion. These small details can lead to large disputes.

Leaving the purpose field generic is a major cause of scope disputes. Always update contact details for the new project. If you are capturing video, ensure you use a video interview consent form instead.

  • Writing 'confidential' without practical definitions
  • Forgetting to address transcription separately from recording
  • Leaving the purpose field generic ('research purposes')
  • Using old contact details from previous projects
  • Forgetting to date both signature lines

What was not needed in this sample

This is a low-risk interview about a business topic. It does not need a distress protocol or a safeguarding contact. Adding irrelevant clauses makes participants take the risk more seriously than it warrants.

Use this filled-in example as a check against your own drafts. Your project name and attribution choice will differ. The value is in seeing how specific, dated and checkable good answers look.

Frequently asked questions

Is this a real interview or a fictional example?

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It is entirely fictional, created to illustrate what a well-completed form looks like. Priya, Marcus and Fenwick University do not exist.

Why does the sample name a specific supervisor?

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Naming individuals makes the access commitment checkable. A vague team reference is harder to answer honestly if a participant asks who heard the recording.

Could Marcus have agreed to audio recording but refused transcription?

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Yes, and that is why the two permissions are separate tick boxes. Some participants are comfortable being recorded but uneasy about a written transcript.

What would change if Marcus wanted full anonymity instead?

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The attribution box would be reworded. The purpose and outputs sections would need review to make sure no other field makes him identifiable by implication.

Why is there no payment or incentive field filled in?

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Marcus was not offered one. Leaving the field blank is ambiguous, so it should either be deleted or explicitly marked 'none'.

Can I use this sample for my ethics committee?

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You can use it as an illustration of good practice. However, most committees will want to see your own project's specific details rather than a fictional example.

Authoritative sources

Official guidance we cross-checked this template against.

Related Consent Forms

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Still required: Participant name (printed).

Participant statements (all boxes ticked in this example)
Signatures