Create an Informed Consent Form

You are a senior MEAL specialist with expertise in research ethics and participant protection. Your task is to create a complete Informed Consent Form template for a data collection activity.

Context:

• Activity name: a descriptive title for this activity
• Organization: the organization conducting this activity
• Target respondents: adult participants in the data collection
• Data collection method: the method used to collect the data
• Topics covered: the main topics addressed
• Sensitive topics (if any): any topics that may be sensitive for respondents
• Vulnerable groups (if any): any vulnerable groups among respondents
• Languages needed: the languages the form should be provided in
• Data storage: how the data will be stored and protected
• Data retention period: a defined retention period consistent with donor and legal requirements
• Applicable regulations: relevant data protection regulations

Deliverables:

Create four consent form versions:

Version 1: Standard Adult Consent Form Structure with these clearly labeled sections:

a. Header

• Organization name and logo placeholder
• Study/activity title
• Form version number and date
• Unique form ID field

b. Introduction

• Greeting and interviewer introduction (first person, conversational)
• Organization description (1-2 sentences)
• Purpose of the data collection in plain language (no jargon, 6th-grade reading level)

c. What We Are Asking You to Do Questions/activities involved, duration, recording if applicable, who else may be interviewed, whether follow-up visits are planned.

d. Voluntary Participation Completely voluntary; right to refuse any question or stop at any time; no penalty or loss of services; include explicit statement: "Your decision will not affect any assistance you receive from the organization."

e. Risks and Benefits Realistic risks (time, emotional discomfort), mitigation measures (skip options, referral to support services), direct benefits (compensation if any), indirect benefits (improving program quality).

f. Confidentiality

• How data will be kept confidential
• Who will have access to identifiable data (specify roles, not just "the team")
• How data will be stored and protected (encryption, passwords, locked cabinets)
• How long data will be retained and when it will be destroyed
• Limits to confidentiality (mandatory reporting of child abuse or imminent harm)
• Whether data may be shared with donors or partners (in anonymized/aggregated form only)

g. Contact Information: Name/contact for study questions, separate contact for complaints (independent of study team), and local referral service contacts (psychosocial support, protection, legal aid).

h. Consent Statement and Signature Block: Summary statement beginning "I have been informed about..."; checkboxes for participation, recording (if applicable), and data sharing consent; participant signature or thumbprint with date; witness and interviewer signatures.

Version 2: Verbal Consent Script Adapt Version 1 as a read-aloud script with interviewer instructions in {brackets}, simplified language, pause points for questions, and a witness attestation section.

Version 3: Parental/Guardian Consent (for studies involving minors) Adapt Version 1 for parents/guardians: add description of what the child will be asked, whether the parent may be present, right to withdraw the child, and a note that the child will also give their own assent.

Version 4: Minor Assent Form (ages 12-17) One-page maximum. Simple age-appropriate language. Confirm that parent has agreed but the child still decides. Reassure that refusal has no consequences. Include a contact for support if they feel upset.

Formatting: Use headers and bullets; 12-point minimum font; avoid legal jargon; note cultural adaptation needs.

Align with UNEG Ethical Guidelines, GDPR Article 7 consent requirements (where applicable), Sphere Protection Principle 1, and IASC Guidelines on Mental Health and Psychosocial Support.