Informed Consent
My name is _____________________ and I am a student in the Sexual Orientation and Public Policy course at the University of Illinois at Springfield for _________ (semester, year).
I am conducting this interview as part of a course assignment. I am going to write a “two generations” paper which examines the life experiences of two gay, lesbian, bisexual, transgendered or queer people of different ages. The paper assignment is designed to help us learn about the similarities and differences of individuals across generations.
The interview will last approximately one hour, and involves answering questions about ______(general topic). I would like to tape record your responses to my questions so I can listen carefully to what you have to say and not have to take notes. Your responses will be completely confidential. No one but me will hear the tape which I will destroy as soon as my paper is completed. If you do not want me to tape record your responses, then I will just take notes. This consent form will be kept separate from the audio tape and any written interview notes.
You do not have to participate at all, or, even if you agree now, you can stop the interview at any time.
Your name will not be mentioned in my paper; I will be creating a fictitious name for you. I will also keep your identity confidential.
A benefit you may experience by participating in this interview is greater
insight into the experiences you discuss with me. I will be asking you
questions about your own personal experiences You can skip questions that
make you uncomfortable, or you can stop the interview at any time for any
reason, without any explanation.
If you have any questions about this project, you may contact my instructor,
Dr. Pat Langley at 217-206-7423, or at plang1@uis.edu
Interviewee's Consent
I have read and understand the description of this interview exercise.
Any questions about the nature and purpose of this interview have been
asked and answered to my satisfaction. I understand that the interview
will be used for educational purposes only and that my responses to all
interview questions will be completely confidential. I understand
that I may terminate the interview or refuse to answer any question at
any time. I further understand that the audio tape of this interview
will be destroyed after it has been reviewed for this student's learning
purposes. I have received a blank copy of this consent form.
My signature below indicates that I agree to participate in this interview
as described.
Print Name: _______________________________________
Signature: _______________________________________
_________ Date
