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Survey Consent Form Template

Ensure Ethical Data Collection with Our Survey Consent Form Template

Gathering feedback without consent can lead to ethical dilemmas and potential legal issues. This survey consent form template is designed to help you secure the necessary permissions from participants before they take part in your research. You can streamline participant onboarding, enhance trust in your surveys, and meet ethical requirements while collecting valuable insights. Plus, the template is WCAG-aligned, ensuring accessibility for all participants. Start using this convenient live template to safeguard your project today.

Email address for a copy of this consent or follow-up (optional)
Are you 18 years of age or older?
Yes
No
I have read and understood the information about this survey.
Strongly disagree
Disagree
Neither
Agree
Strongly agree
I understand that my participation is voluntary and I can stop at any time before submitting my responses.
Strongly disagree
Disagree
Neither
Agree
Strongly agree
I understand how my responses may be stored, used, and shared.
Strongly disagree
Disagree
Neither
Agree
Strongly agree
I understand any potential risks or discomforts have been explained.
Strongly disagree
Disagree
Neither
Agree
Strongly agree
If this survey includes audio, video, or screen recording, I consent to that recording.
Yes, I consent
No, I do not consent
Not applicable
I consent to the use of my de-identified responses for future research.
Yes
No
I agree to be contacted about follow-up studies.
Yes
No
I would like to receive a copy of this consent by email.
Yes
No
Type your full name to sign.
Date of consent.
Do you consent to participate in this survey?
Yes
No
{"name":"Email address for a copy of this consent or follow-up (optional)", "url":"https://www.quiz-maker.com/QPREVIEW","txt":"Email address for a copy of this consent or follow-up (optional), Are you 18 years of age or older?, I have read and understood the information about this survey.","img":"https://www.quiz-maker.com/3012/images/ogquiz.png"}
Paper art illustration highlighting a survey consent form with engaging design elements for FormCreatorAI article.

When to use this form

Use this form when you need clear, documented permission before collecting survey responses. It fits academic studies, product research, employee pulse checks, and campus questionnaires. Share purpose, time to complete, any risks, incentives, data use, and withdrawal rights, then capture a formal yes or no. For remote or hybrid projects, pair it with the Electronic informed consent form. If you process EU or UK personal data, mirror language from the GDPR Consent form. For group-based topics where privacy matters, review the Group therapy confidentiality form to explain how you will protect identities. You get a defensible audit trail, fewer disputes, and higher trust, which improves response quality.

Must Ask Survey Consent Questions

  1. Do you agree to take part in this survey?

    This creates a clear, auditable opt-in that protects you and participants. A direct yes or no builds trust and keeps your results ethically sound.

  2. Have you read and understood the study purpose, time required, risks, and benefits?

    Confirming understanding makes consent informed, which reduces complaints and drop-offs. If the survey supports a broader process, align wording with the Procedure consent form for consistency.

  3. Are you at least 18 years old, or do you have parent or guardian permission?

    This helps you screen for legal eligibility and meet policy requirements. It prevents collecting data you cannot use.

  4. Do you consent to the collection, storage, and anonymized use of your responses, including any personal data you share?

    Stating how you handle data boosts transparency and compliance. It sets clear boundaries for processing and reporting.

  5. May we contact you later about your responses, and what is your preferred contact method?

    Explicit recontact consent protects against spam complaints and clarifies expectations. Capturing the channel (email, phone) improves follow-up quality.

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