surveys template

7/29/2019 Surveys Template

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UNIVERSITY OF MASSACHUETTS AMHERST

HUMAN SUBJECTS INSTITUTIONAL REVIEW BOARD

Guidelines for Creating an Informed Consent Cover Letter for No-Risk Surveys

On the next page is a template for creating a cover letter for surveys where there is little or no risk to therespondents. The same principles, however, must apply to crafting this letter as to any other informed

consent document. These include:

Potential respondents must be given all the information that might reasonably be expected to

influence their willingness to participate.

The information must be presented in simple language so as to be easily understood by persons

unfamiliar with research or the specific research topic. A sample letter written at the 8 th grade level

is attached.

Implicit consent may be approved for studies in which the researcher asks participants to

complete a questionnaire that involves no more than minimal risk. Implicit consent means that

completion and return of the questionnaire may be taken to document consent. The cover letter may

contain wording that says that something to the effect that by completing and returning the survey

you have shown your agreement to participate in the study.

Address the person you are writing to in the second person.

If oral consent is to be obtained the PI should provide the IRB with a script of how the project will

be described to the participant. Where oral consent is obtained participants should still be provided

with a written document describing the study and providing the name and contact information for

the PI and IRB.

The letter template attached is a starting point that you can tailor to your study and subjects. You

must ensure that your informed consent materials contain the following elements:

A statement that the study involves research

A simple descriptive title of the project

Name and phone number of the Principal Investigator (students must have a faculty advisor

sponsor them as the PI).

A clear statement of the research purpose(s)

A clear explanation of the procedures to be followed

A statement about the risks or benefits, including the societal benefits of the knowledge to

be gained from the survey

A statement of costs to the participants if there are any

A description of how confidentiality will be maintained and who will have access to the data

A statement to the effect that a participant is free to refuse to participate

Contact information if the participant has further questions about the survey

IRB contact information: The Institutional Review Board (IRB) at the University of

Massachusetts Amherst has approved this study. If you have any concerns about your rights

as a participant in this study you may contact the Human Research Protection Office via

email ([email protected]) or by telephone (413-545-3428).

A cover letter with the same elements for the parent to read and sign if the survey subjects

are minors
mailto:[email protected]:[email protected]


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UNIVERSITY OF MASSACHUSETTS AMHERST

HUMAN SUBJECTS INSTITUTIONAL REVIEW BOARD

Template for cover letter for surveys to provide informed consent.

If your research involves carrying out a survey, and there is no risk to your respondents if they

participate, a simple cover letter will be sufficient to gain your subjects informed consent toparticipate in the study. The letter template below includes all the elements needed in an informedconsent document. Following the template is a sample letter written at the eighth grade level.

Dear Respondent,

I am inviting you participate in a research project to study xxxx. [This research project is funded by

xxxx.] Along with this letter is a short questionnaire that asks a variety of questions about xxxx. I

am asking you to look over the questionnaire and, if you choose to do so, complete it and send [orgive] it back to me. It should take you about xxxx minutes to complete.

The results of this project will be [say what its for]. Through your participation I hope tounderstand xxxx. I hope that the results of the survey will be useful for [xxxx] and I hope to share

my results by [publishing them in a scientific journal][presenting them on the web where students

all over the world can use them]

I do not know of any risks to you if you decide to participate in this survey and I guarantee that

your responses will not be identified with you personally (or make some statement about

confidentiality.) I promise not to share any information that identifies you with anyone outside myresearch group which consists of me [and xxxx]. [You should not put your name on the

questionnaire.] If you do not feel comfortable handing in your survey to me (or your teacher), you

may also . . .[put option here, e.g., mail it to the following address, drop it off at X office]

The survey should take you about xxxx minutes to complete. I hope you will take the time to

complete this questionnaire and return it. Your participation is voluntary [and there is no penalty ifyou do not participate]. Regardless of whether you choose to participate, please let me know if you

would like a summary of my findings. To receive a summary, xxxx.

If you have any questions or concerns about completing the questionnaire or about being in this

study, you may contact me at xxxx. The Institutional Review Board (IRB) at the University of

Massachusetts Amherst has approved this study. If you have any concerns about your rights as a

participant in this study you may contact the Human Research Protection Office via email([email protected]) or by telephone (413-545-3428).

Sincerely.

Justin Time,

Associate Professor


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Sample cover Letter for surveys 8th grade level

Title: Hiking in National Parks: What Makes a Good Experience.

Dear hiker,

I am inviting you to participate in my research project to survey hikers to find out what they are

looking for when they hike in our National Parks. My work is funded by the National Park Service.

I want to understand what hikers like best about our Parks and how the Parks can be improved for

hiking. I have attached a short survey about hiking in National Parks which I am hoping you willfill out and return it to me. It should take you about twenty minutes to complete. The National

Park Service will use what I find out through this survey to make sure everybodys hiking

experience is the best it can be.

You will see that I have all sorts of questions about hiking at National Parks. If you choose to

participate in my survey please fill in your answers and send (or give) the survey back to me. Youshould not put your name on the survey when you fill it out, and I promise that I will respect your

privacy. I will make sure that your answers cannot be linked to you personally when I send my

results to the National Park Service.

There are no risks to you or to your privacy if you decide to join my study by filling out this survey.

But if you choose not to participate that is fine. Even if you decide not to respond I would be very

happy to share my results with you if you are interested. To get a copy of my results call me at 547-0233.

If you have any questions about the survey, or about being in this study, you may contact me at547-0233. The Institutional Review Board (IRB) at the University of Massachusetts Amherst has

approved this study. If you have any concerns about your rights as a participant in this study you

may contact the Human Research Protection Office via email ([email protected])

or by telephone (413-545-3428).

Sincerely.

Theresa Green,Associate Professor

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