SIMPLE & BASIC — 1 PAGE

Simple Interview Consent Form

A free, simple one-page interview consent form. Basic, plain-language design covering all essential elements — perfect for student projects, small research, and informal journalism.

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✓ 100% Free ✓ No Sign-Up ✓ PDF & Word ✓ IRB-Compliant

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Participant Full Name Study / Project Title Researcher / Interviewer Name Institution / Organization Interview Date Estimated Duration Will the interview be recorded? Confidentiality Level Researcher Contact Email

PREVIEW

Participant Name

Enter participant name above

Study Title

Enter study title above

Researcher / Interviewer

Enter researcher name above

Institution

Enter institution above

Interview Date

Select date above

PURPOSE: You are invited to participate in a research interview. The purpose is [study title].

VOLUNTARY: Participation is completely voluntary. You may withdraw at any time without penalty.

RECORDING: This interview will be audio and/or video recorded.

CONFIDENTIALITY: All responses will be kept confidential.

PARTICIPANT SIGNATURE: ___________________________ Date: __________

RESEARCHER SIGNATURE: ___________________________ Date: __________

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What to Include

Researcher/interviewer name and contact
Study or project title
One-sentence description of the interview purpose
Estimated interview duration
Recording yes/no checkbox
Simple confidentiality statement
Voluntary participation statement
Participant signature and date

Sample

Simple Interview Consent Form — Sample Text

SIMPLE INTERVIEW CONSENT FORM

Researcher: _________________________ Contact: _______________________
Project Title: ___________________________________________________
Date: ___________________

─────────────────────────────────────────────────────────

PURPOSE
I am conducting an interview about [topic] for [purpose: my research / a class
project / an article]. The interview will take approximately [duration].

RECORDING
Will this interview be recorded?  [ ] Yes  [ ] No

CONFIDENTIALITY
Your responses will be kept confidential. [Choose: Your name will not be
used / A pseudonym will be used / You will be identified with your consent.]

YOUR RIGHTS
• You do not have to answer any question you are not comfortable with
• You may stop the interview at any time
• Participating is completely voluntary

─────────────────────────────────────────────────────────

I understand and agree to participate in this interview.

Participant Signature: ______________________ Date: __________

Researcher Signature:  ______________________ Date: __________

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FAQ

Frequently Asked Questions

When should I use a simple consent form instead of a detailed one? ▼

Use a simple consent form for low-risk, informal interviews such as student class projects, simple oral history interviews, and informal journalism. For formal academic research, IRB submissions, or medical research, use a more detailed informed consent form.

What is the minimum a consent form needs to include? ▼

At minimum: who is conducting the interview, what it's for, whether it will be recorded, a basic confidentiality statement, and a voluntary participation statement with a signature line.

Can a simple consent form be handwritten? ▼

Yes. A handwritten consent form is perfectly valid as long as it clearly states the key consent elements and is signed by the participant. Keep a copy for your records.

Is a simple consent form appropriate for classroom research? ▼

Yes. For classroom-based projects and course assignments, a simple one-page consent form is usually sufficient. Check with your instructor for any specific requirements.

Can I adapt this simple form for a journalism interview? ▼

Yes. Add a line for publication name and attribution preferences (on record / off record), and you have a workable journalism consent form. See our journalism interview consent form for a more complete version.

Mudit Agarwal

Digital Marketing Specialist & Web Content Researcher

Mudit Agarwal is a digital marketer with 8+ years of experience in content strategy and web publishing. He built ConsentForms.xyz to help researchers, journalists, UX designers, and students access professionally structured consent templates. All templates are researched against IRB guidelines, APA standards, and institutional requirements. Learn more →

📅 Last reviewed: June 2026 • LinkedIn Profile