What Is a Dissertation Interview Consent Form?
A dissertation interview consent form is a written document that a research participant signs before taking part in an interview conducted as part of a student's dissertation or thesis project. It formally records that the participant agrees to be interviewed, understands how their data will be used, and is aware of their right to withdraw at any time.
Unlike a general interview consent form, the dissertation version must include university-specific information: your ethics approval reference number, your supervisor's contact details, your degree level and programme, and a clear statement about how findings will appear in your submitted work. Most institutions require this form as part of their IRB or ethics committee application before any fieldwork can begin.
Whether you are conducting semi-structured qualitative interviews, focus groups, or oral history sessions, this consent form protects both you as the student researcher and your participants — giving you documented permission to use the material in your dissertation and any subsequent publications.
What to Include in a Dissertation Interview Consent Form
A dissertation interview consent form must meet both your university's ethics requirements and the standards of a general informed interview consent form. Every element below should be present — ethics committees regularly reject applications for missing items.
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Dissertation Title and Degree LevelFull dissertation title plus your degree programme (PhD, MSc, MA, BA) and university department.
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Student Researcher and Supervisor DetailsYour name, student ID or email, and your supervisor's name, department, and contact email as a second point of contact.
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Ethics Approval Reference NumberThe reference issued by your institution's IRB or ethics committee. Required at most universities before conducting any research interviews.
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Research Purpose and Interview DescriptionA plain-language summary of what your dissertation is about and what the participant will be asked during the interview.
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Recording and Transcription ArrangementsWhether the interview will be audio recorded, video recorded, or transcribed. State who has access and when recordings will be deleted. For online interviews, see our online interview consent form.
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Confidentiality and AnonymisationHow participant identity will be protected — pseudonyms, anonymised transcripts, restricted access — and the data retention period after examination.
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Voluntary Participation and Withdrawal RightsClear statement that participation is voluntary and the participant may withdraw at any time without academic, professional, or personal consequence.
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How Findings Will Be UsedState that findings will appear in the dissertation and potentially in academic publications or conference presentations.
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Participant and Researcher Signature LinesPrinted name, signature, and date fields for both the participant and the student researcher. For online interviews, email confirmation is accepted at many universities.
How to Write a Dissertation Interview Consent Form
Follow these 8 steps to write a dissertation interview consent form that satisfies your university's ethics committee. For the full guide, see How to Write an Interview Consent Form.
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State the Dissertation Title and Degree Level
Include the full dissertation title, your degree programme (PhD, MSc, BA), your name, and your university department at the top of the form. Use the exact dissertation title as registered with your institution.
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Add Ethics Approval Details
Include your university ethics committee name and approval reference number. Most universities — including those using an IRB process — require this before any fieldwork begins. Contact your department's research support office if you have not yet applied.
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Describe the Research Purpose and Interview Format
Explain what your dissertation research aims to achieve in plain, jargon-free language. State the interview format — whether it will be a semi-structured qualitative interview, a structured interview, or an oral history session — and the expected duration.
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Specify Recording and Transcription
State clearly whether the interview will be audio recorded, video recorded, or transcribed. Specify who will access the recording (you and your supervisor only), and when recordings will be permanently deleted after submission. See also our recording interview consent form.
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Explain Confidentiality and Data Storage
Describe how participant data will be anonymised — typically using pseudonyms — stored securely (encrypted storage, password-protected files), and deleted after the dissertation examination period. Disclose clearly if your supervisor will have access to transcripts as part of their supervisory role.
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Add the Voluntary Participation Statement
Confirm that participation is entirely voluntary and that the participant may withdraw at any time without penalty. Crucially for dissertation research, state explicitly that withdrawal will not affect the participant's academic, professional, or personal relationship with you or your institution.
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Include Supervisor as Second Point of Contact
Add your dissertation supervisor's full name, email address, and department. Participants must be able to raise concerns independently of the student researcher. This is a standard requirement at most UK and US universities for research interview consent forms.
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Add Signature and Date Lines
Include printed name, signature, and date fields for both the participant and yourself as the researcher. For online and Zoom interviews, a written email reply confirming consent is accepted at many institutions as an alternative to a physical signature.
Dissertation Interview Consent Form — Sample Text
DISSERTATION INTERVIEW CONSENT FORM Dissertation Title: [Full Dissertation Title] Degree Programme: [PhD / MSc / MA / BA], [Department] Student Researcher: [Full Name] — [student@university.edu] Supervisor: [Supervisor Name], [Department] — [supervisor@university.edu] Institution: [University Name] Ethics Approval Ref: [XXXXXXXX] — [Ethics Committee Name] ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ ABOUT THIS RESEARCH I am a [degree level] student at [University Name] conducting dissertation research on [topic area]. This study has received ethics approval from [ethics committee name], reference [XXXXXXXX]. PURPOSE This research aims to [describe your dissertation research question and objectives in plain language]. Your participation will contribute to [describe the significance of your research]. THE INTERVIEW If you agree to participate, I will conduct a [semi-structured / in-depth / structured] interview lasting approximately [duration, e.g. 45 minutes]. The interview will take place [in person at location / via Zoom / by phone]. I will ask you questions about [topic areas]. RECORDING AND TRANSCRIPTION With your permission, the interview will be audio recorded. The recording will be transcribed and then permanently deleted. Transcripts will be accessible only to myself and my dissertation supervisor. If you prefer not to be recorded, I will take notes only. CONFIDENTIALITY AND ANONYMITY Your name will not be used in my dissertation. You will be referred to by a pseudonym throughout the write-up and in any subsequent publications. All data will be stored in encrypted, password-protected files accessible only to myself and my supervisor. Data will be deleted upon completion of the examination process, typically within [timeframe] of submission. VOLUNTARY PARTICIPATION Your participation is entirely voluntary. You may withdraw at any time and for any reason without needing to provide an explanation. Withdrawing will have no effect on any academic, professional, or personal relationship. HOW FINDINGS WILL BE USED Results will be reported in my dissertation and may subsequently be used in academic journal articles or conference presentations. Individual participants will not be identifiable in any outputs. ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ CONSENT I confirm that I have read and understood the information above. I have had the opportunity to ask questions. I agree to participate in this interview voluntarily. [ ] I agree to the interview being audio recorded. [ ] I agree to the interview being video recorded. [ ] I do not consent to recording (notes only). Participant Name (print): ________________________________ Participant Signature: ___________________________________ Date: __________ Researcher Signature: ___________________________________ Date: __________ ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ PARTICIPANT COPY: Please retain a copy of this consent form for your records. RESEARCHER COPY: To be filed securely for the duration of the study.
Dissertation Interview Consent Forms by University
Different universities have slightly different requirements for dissertation interview consent forms. The sample above covers all standard elements. Adapt it with your institution's specific boilerplate using the guidance below. For IRB-specific requirements, see the IRB interview consent form page.
Pepperdine University
Pepperdine's IRB requires its IRB-approved consent form template, including CCPA data rights language, the IRB contact number, and faculty supervisor details. Download the template above and add Pepperdine's required boilerplate from the Pepperdine IRB portal before submission.
Pepperdine IRB Portal →Southern New Hampshire University (SNHU)
SNHU requires students to use its institutional consent form template, downloadable from the SNHU student portal. The SNHU interview consent form must include the student's SNHU ID number and supervising faculty member's name and email. The PDF version is widely referenced as the SNHU interview consent form PDF. For the journalism programme specifically, see our journalism interview consent form.
SNHU IRB Information →University of Edinburgh
The University of Edinburgh requires ethics approval via the Research Ethics committee for all dissertation research involving human participants. The consent form must reference the School Research Ethics panel reference number and include the Principal Investigator (supervisor) as a named contact.
Edinburgh Research Ethics →UCL (University College London)
UCL's Research Ethics Committee requires consent forms to include UCL's data protection officer contact, a GDPR-compliant data handling statement, and the specific UCL ethics application reference. The template above covers all standard elements — add UCL's boilerplate from the UCL Research Ethics online system.
UCL Research Ethics →UTS (University of Technology Sydney)
UTS requires all human research to be approved by the UTS Human Research Ethics Committee (HREC). Dissertation consent forms must include the UTS HREC approval number, a plain-language statement of participant rights, and contact details for both the student and supervising researcher.
UTS HREC →TCD (Trinity College Dublin)
Trinity College Dublin requires ethics approval for all dissertation research involving human participants via the School Research Ethics Committee. The consent form must include the TCD ethics application reference and a GDPR-compliant data statement covering data retention and participant rights under GDPR Article 17.
TCD Research Integrity →Thesis Interview Consent Form
A thesis interview consent form serves the same purpose as a dissertation consent form, but the terminology "thesis" is more commonly used for undergraduate final-year projects and master's-level research in the UK, Australia, and Ireland, while "dissertation" typically refers to doctoral-level work in these regions. In the United States, "dissertation" usually refers to doctoral research and "thesis" to master's-level work.
Regardless of terminology, the elements of your consent form are identical: ethics approval reference, researcher and supervisor details, recording consent, confidentiality provisions, and voluntary participation statement. Download the sample above — it works equally well as a thesis interview consent form or dissertation consent form.
For student-level projects below dissertation or thesis level — including AP Research, undergraduate independent study, and school history projects — see our dedicated student interview consent form, which includes simplified language and parent consent provisions for interviewing minors.