Você está na página 1de 3

Parent/Guardian Informed Consent Agreement

Color and Memory


Please read this consent agreement carefully before you decide to participate in the study.
Your child will also receive an assent form; please review the assent form with your child.

Purpose of the research study: The purpose of the study is to learn which colors effect memory
the most.

What your child will do in the study: Your child will be asked to look at 6 sentences in 6
different colors in this study your child’s responses will be recorded anonymously. Your child
will be given 6 different sentences in 6 different sentences. They will be given 30 seconds to
look at the sentences; 5 seconds per sentence After 30 seconds your child will be asked to
write down what they remember.

What you will do in the study: During this study I will administrate the sentences and gather
responses. Along with keeping time.

Time required: The study will require about 5 minutes of your time.
Risks: There are no anticipated risks in this study.

Confidentiality: Everything will be anonymous. Your child’s name will not be included anywhere
in the study.

Anonymous data:
The information that you and your child gave in the study will be handled confidentially. Your
data and your child’s data will be anonymous which means that your name will not be collected
or linked to the data. If it is possible to deduce the participant’s identity, state the following:
Because of the nature of the data, it may be possible to deduce your child’s identity and/or
your identity; however, there will be no attempt to do so and your data will be reported in a
way that will not identify your child.

Voluntary participation: Your child’s participation in the study is completely voluntary. Your
child’s grades will not be affected during this study.

Right to withdraw from the study: You have the right to withdraw your child from the study at
any time without penalty

How to withdraw from the study


Your child want to withdraw from the study, tell the researcher. There is no penalty for
withdrawing. If you would like to withdraw after your materials have been submitted, please
contact Olivia Mack.
Payment: You will receive no payment for participating in the study.

If you have questions about the study, contact:

Researcher's Name: Olivia Mack


Telephone: (972)-679-0380

Teachers Name: Cameron Williams

Agreement:
I agree to allow my child to participate in the research study described above.
I agree to participate in the research study described above.

Signature: _____________________________________________ Date: _____________


You will receive a copy of this form for your records
Assent Form: Color and Memory
Please read this assent agreement with your parent(s) or guardian(s) before you decide to
participate in the study. Your parent or guardian will also give permission to let you
participate in the study.

We want to learn about how color effects memory.

As part of our study, we would like to ask you to look at 6 sentences. You will have 5 seconds
per sentence. After all sentences are viewed you will wait 30 seconds before writing what all
you remember in the sentences. This study should take 5 minutes altogether. A brief amount of
class time will be taken up.

 We don’t think that there are any risks to you in this study.

 If you participate in this study, there won’t be any benefit to you.

 The information that you give to us will not have your name on it, so we won’t know
what answers you give us.

 You don’t have to participate in this study.


 You can stop doing the study at any time.

If you want to stop doing the study, tell Olivia Mack, but if the study has begun them simply sit
quietly as to not disrupt others and turn your paper over. There is no penalty for stopping. If
you decide that you don’t want your materials in the study but you already turned them in,
contact Olivia Mack.

You won’t receive any money if you do the study.


If you have questions about the study, contact:
Olivia Mack
Phone: 679-0380
Teacher: Cameron Williams

Agreement:
I agree to participate in the research study described above.

Signature: _____________________________________________ Date: _____________


You will receive a copy of this form for your records.

Você também pode gostar