What You Need to Know to Participate

Study Title:

The Effects of Sleep on Memory in Adults

Principal Investigator:

Dr. Jane Smith
Department of Psychology
University of Maine
Phone: (207) 555-1234
Email: jane.smith@maine.edu

Introduction:

You are invited to participate in a research study. Before you decide, it is important that you understand what the research involves. Please read the following information carefully and ask any questions you may have.

Purpose of the Study:

The purpose of this study is to examine how sleep affects memory in adults aged 18-65.

Procedures:

If you agree to participate, you will be asked to:

• Complete a brief questionnaire about your sleep habits (10 minutes).
• Participate in a memory test before and after a night of sleep (30 minutes each session).
• Wear a sleep tracking device overnight.

Risks and Discomforts:

There are minimal risks associated with this study. You may feel slightly tired from the memory tests or uncomfortable wearing the sleep tracker.

Benefits:

You may not benefit directly, but your participation will help us better understand the relationship between sleep and memory.

Confidentiality:

All information collected will be kept confidential. Your name will not be used in any reports or publications. Data will be stored securely and only accessible to the research team.

Voluntary Participation:

Your participation is voluntary. You may refuse to participate or withdraw at any time without penalty or loss of benefits.

Contact Information:

If you have any questions about this study, please contact Dr. Jane Smith at (207) 555-1234.
If you have questions about your rights as a research participant, contact the University of Maine Institutional Review Board at (207) 555-5678.

Consent Statement:

I have read and understood the information above. I have had the opportunity to ask questions and my questions have been answered. I agree to participate in this study.

Participant’s Name (printed): __________________________________

Participant’s Signature: ______________________________________

Date: ___________________

Researcher’s Signature: ______________________________________

Date: ___________________

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Note:
This is a general template. Always tailor the form to your specific study or procedure and ensure it meets the requirements of your institution or relevant regulatory body.