Informed Consent Form
CS 6903 (section 1) Prototype Evaluation Study
Principal Investigators:
[Your names here]
Faculty of Computer Science
Dalhousie University
We invite you to take part in a research study at Dalhousie University. Taking part in this
study is voluntary and you may withdraw from the study at anytime. There will be no
repercussion from choosing not to participate in this study. The study is described below.
This description tells you what you will be asked to do and includes any risks or
inconvenience you might experience.
Participating in the study may not benefit you directly but we might learn things about
the design of interfaces for reading from computer screens that will benefit others. There
is no compensation for participating in this study and you may terminate your
participation in the study at any time without prejudice. You should discuss any questions
you have about this study with either of the principal investigators or with the people
administering the study.
The purpose of this study is to evaluate how some features of a computer-based reading
program can help readers of scholarly journal articles. The study consists of a single
session in which you will be asked to complete some reading tasks using a computer
program or simulated computer program and filling out a short questionnaire when you
are finished. All personal and identifying data will be kept confidential. No personal
identifiable information will be used in the study results.
In the event that you have any difficulties with, or wish to voice concern about, any
aspect of your participation in this study, you may contact the Human Research
Ethics/Integrity Coordinator at the Dalhousie University Office of Human Research
Ethics and Integrity for assistance. The phone number is (902) 494-1462.
I have read the explanation about this study. I have been given the opportunity to discuss
it and my questions have been answered to my satisfaction. I hereby consent to take part
in the study. However, I realize that my participation is voluntary and that I am free to
withdraw from the study at any time.
Participant: Researcher:
Name:……………………………….. Name:…………………………………..
Signature:…………………………… Signature:………………………………
Date:………………………………… Date:……………………………………