Fillable Printable Parental Consent Form - Miami

Parental Consent Form - Miami

Parental Consent Form

This form is for students in Introduction to Psychology at Miami University who have not reached the age of 18 years.

The Department of Psychology at Miami University maintains a Research Experience Requirement as part of its introductory

psychology course (PSY 111). The purpose of this requirement is for course participants to learn about research in the

department as subjects. As examples of the types of research activities going on in the department, participants may be asked

to complete surveys, view and respond to a variety of displays, complete memory tasks or tasks involving activities in virtual

environments.

Any student who wishes to serve as a subject in an experiment must sign a written consent form, which is intended to

indicate that the participant understands:

 The types of activities in which he/she will engage in the experiment

 That his/her participation is voluntary

 That he/she has the right at any time to withdraw from the experiment without penalty

A final condition for completing the consent form is that the participant acknowledges that he/she is at least 18 years old.

Because your son/daughter is not currently 18 years old, the Department of Psychology must obtain your written consent to

allow them to participate. This written consent will be kept by the Department of Psychology. At the time of the experiment,

your son/daughter will sign the consent form indicating that they are under the age of 18 years old and have written parental

consent on file with the department.

All of the research in the department has been reviewed and approved by the Miami University Institutional Review Board

(MUIRB), which supervises and oversees all research involving human subjects. Most of the approved research entails what

is commonly referred to as “minimal risk.” This means that in the judgment of the members of the MUIRB, the study does

not pose any significant physical or psychological risks to participants. In the unlikely event that a participant does

experience some discomfort, the researchers are responsible for providing participants with referrals to people or agencies

that can assist them. Such events are extremely rare in research that is approved as minimal risk.

Because your son/daughter is not 18 years old, they must have your consent to participate in research as a subject. In giving

your consent, it is understood that this applies only to research that has been judged as involving minimal risk to participants.

You may also withdraw your consent at any time by calling 513-529-2400 or emailed Dr. Leonard J. Smart

(smartlj@MiamiOH.edu), Associate Professor of Psychology and Chair of the Psychology DRB.

1. I hereby give my consent for_______________________________________________ to participate as a subject in

ongoing research in the Department of Psychology at Miami University.

2. I understand that I may withdraw my consent at any time and my son/daughter will not be penalized and will be

provided with opportunities to complete the research experience requirement that do not involve research

participation. My son/daughter may withdraw their consent at any time during the experiment without penalty.

3. If you/your child have any questions about your child’s rights as a participant in a research study, he/she may

contact the Miami University Office for the Advancement of Research and Scholarship at 513-529-1757 or email

Your Name_____________________________________________________ Date__________________

Your Signature________________________________________________________________________

Relationship to the above student if not a parent______________________________________________