Human Participants in Research
Online form for sociology, anthropology, & social work

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YOU may either submit a paper copy of the Human Participants form or submit the form below on-line. Paper copies of the form are available in the department office -- 218 Tisch Learning Center.

If you submit this form on-line, send any supplementary materials as attachments and ask your instructor or thesis advisor to send an e-mail message to Jacqueline Azzarto, the department Institutional Review Officer, at jazzarto approving your use of human participants in your research.

Answer the following questions as they pertain to your proposed research:

1. Principle Researcher Information
Name(s)
Address
Telephone (XXX)XXX-XXXX xt XXX
E-Mail


2. Project Information

Title
Brief Description


3. Location of Study

Location


4. Dates of Data Collection Phase of Study

From MM/DD/YYYY
To MM/DD/YYYY

Answer questions 5-10 in the spaces provided below, or type your responses separately using a word-processing program, and submit the file at the end of this page:


5. Recruitment and Use of Participants

Describe procedures related to subject participation, including details concerning:

  1. Who participants are (e.g., students, Saratoga springs residents, etc.).
  2. How many participants will be involved and how they will be recruited.
  3. What the participants will do or what will be done to them.

  4. Attach a copy of any research tools to be used (e.g., questionnaires, interview protocols).


6. Deception of Participants

Will your research involve any deception? If so, explain how participants will be deceived and why.


7. Consent of Participants

How will you obtain participants' informed consent?


8. Risk to Participants

Do you see any chance that participants will be harmed in any way? How will you minimize risks to participants?


9. Debriefing Participants

Describe procedures you will use to debrief your participants. What will be said to the subjects?

If you will present something to the subjects, attach it here:


10. Anonymity and Confidentiality

How will you insure the anonymity of participants who desire it and/or the confidentiality of the information collected?

 

If you would like to answer questions 5-10 in a separate file, attach it here:


I have not knowingly presented any false or deceitful information here.

       

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