Consent Form:
We are performing an experiment for the internal assessment of our IB Psychology class. We are
investigating the effect on recall of a heard passage if given context in the form of an image and
without context. You will be asked to write a free recall of what you remember from the passage,
asked to rate how easily you understood it on a scale of 1-7, 1 being very hard, 4 being moderate and
7 being easy. then asked to fill out a questionnaire. Your data will be kept confidential however used to
establish the connection between our two variables: context and no context.
I ______________________ voluntarily agree to participate in this research study.
I understand that even if I agree to participate now, I can withdraw at any time or refuse to answer
any question without any consequences of any kind.
I understand that I can withdraw permission to use data from my written responses within two weeks
after the experiment, in which case the material will be deleted.
I have had the purpose and nature of the study explained to me in writing and I have had the
opportunity to ask questions about the study.
I understand that participation involves giving an in depth explanation of what I have understood from
a heard passage. I will be writing down what I remember as well as answering several questions, In
the form of a questionnaire.
I understand that all information I provide for this study will be treated confidentially. Therefore those
who will be able to identify my data as my own are the researchers involved and they will not disclose
this information to anyone outside of the study; my data will be stored on a secure password protected
device.
I understand that in any report on the results of this research my identity will remain anonymous.
I understand that disguised extracts from my results may be quoted in the report. I understand that
under freedom of information legalisation I am entitled to access the information I have provided at
any time while it is in storage.
I understand that I am free to contact any of the people involved in the research to seek further
clarification and information.
I understand that after the experiment has concluded I will be given the opportunity to view the results
as well as ask any further questions about my data and the experiment. I will be given the opportunity
to withdraw then.
Contact information:
mary.obafemi@scarboroughcollege.co.uk
karina.froehlich@scarboroughcollege.co.uk
nicola.keulder@scarboroughcollege.co.uk
richard.bechler@scarboroughcollege.co.uk
Signature of research participant:______________ Date:_____________
