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UC Berkeley, Word Doc Version
U of T, Word Doc Version

STATEMENT OF INFORMED CONSENT

Interaction Designers from [insert Department/University/organization/group] are conducting feedback sessions in order to understand any problem areas for Fluid components. This information will be used to improve the design and development of user interface components and other deliverables for the Fluid Project (http://www.fluidproject.org).

The Fluid Project is an open, collaborative project to improve the user experience of community source software projects such as the [insert name(s) or applications users might be familiar with]. There are no benefits to you for participating, other than perhaps helping to improve the user experience of these community source software projects. We hope that the research will benefit users of the systems working with the Fluid Project, as well as anyone using the Fluid's open source components or other deliverables.

This research poses no risks to you other than those normally encountered in daily life. All of the information from your session will be kept confidential. Your data will have a number associated with it. After the research is completed, we may save the notes for future use by ourselves or others, but your name will not be included.

Your participation in this research is voluntary, and you are free to refuse to participate or quit the interview and observation session at any time. Whether or not you choose to participate will have no bearing in relation to your standing in any department of [insert university/organization].

If you have questions about the research, you may contact:

  • [insert Test facilitator's name, phone, email address]
  • [insert Test note taker's name, phone, email address]
  • [insert anyone else participating in testing's name, phone, email address]

You may keep a copy of this form for reference.
The details of this study were explained to me by:

Investigator Name: _______________________________________________________

Date: ___________________


I have read the above project description. I agree with the terms and hereby consent to participate in the study.

Participant Signature: ____________________________________________________

Participant Name (please print): _____________________________________________

Date: ___________________