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Interview Consent Form Sample & Examples

View and download real interview consent form samples and examples. Covers research, journalism, dissertation, UX, and podcast use cases. Copy or download free.

Sample 1

Basic Interview Consent Form Sample

A general-purpose sample suitable for any interview type.

INTERVIEW CONSENT FORM

Study Title: [Insert Study Title]
Researcher: [Researcher Name], [Institution]
Contact: [Email Address] | [Phone Number]

━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━

PURPOSE
You are invited to participate in a research interview. The study aims to [describe
research objective]. This project has been approved by [IRB/Ethics Board Name],
Protocol No. [XXXX].

WHAT YOU WILL BE ASKED TO DO
You will be interviewed for approximately [duration]. The interview will cover topics
related to [subject matter]. With your permission, the interview will be [audio/video]
recorded for transcription purposes only.

YOUR RIGHTS
• Participation is entirely voluntary
• You may withdraw at any time without penalty
• You may decline to answer any question
• You may request that recording be stopped at any time

CONFIDENTIALITY
All information you provide will be kept confidential. [Describe storage method,
anonymization approach, and data retention period.]

RISKS AND BENEFITS
The risks of participation are minimal. There are no direct benefits to you, though your
participation will contribute to [research purpose].

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CONSENT

I have read and understood the information above. I voluntarily agree to participate.

Participant Name (print): ______________________________

Participant Signature: _______________________________ Date: __________

Researcher Signature: ________________________________ Date: __________
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Sample 2

Sample Consent Form for Research Interview

Comprehensive IRB-compliant sample for academic research interviews.

RESEARCH INTERVIEW CONSENT FORM — SAMPLE

Study Title: [Insert Study Title Here]
Principal Investigator: [Name, Degree], [Department]
Institution: [University/Organization Name]
IRB Protocol No.: [XXXXXX]
Contact: [email] | [phone]

─────────────────────────────────────────────────────────

INTRODUCTION
You are being asked to participate in a research study. Please read this form
carefully. Ask questions about anything you do not understand before deciding
whether to participate.

PURPOSE OF THE STUDY
The purpose of this study is to [describe the research objective and significance].
Approximately [number] participants will take part in this study.

WHAT YOU WILL BE ASKED TO DO
You will participate in a one-on-one interview lasting approximately [duration].
The interview will be conducted [in person / via Zoom / by telephone] and will
cover topics related to [subject area]. With your permission, the interview will
be audio recorded to ensure accuracy of transcription.

RISKS
The risks to you are minimal. You may find some questions sensitive or
uncomfortable. You are not required to answer any question you do not wish to answer.

BENEFITS
There are no direct benefits to you. Your participation contributes to advancing
knowledge about [topic].

CONFIDENTIALITY
Your responses will be kept confidential. Your name will not be used in any
publication. Data will be stored on a password-protected computer accessible
only to the research team and deleted after [retention period].

VOLUNTARY PARTICIPATION
Your participation is entirely voluntary. You may refuse to participate or
withdraw at any time without consequence.

─────────────────────────────────────────────────────────

STATEMENT OF CONSENT

I have read and understand the above information. I voluntarily agree to
participate in this interview.

Participant Signature: ______________________________ Date: ____________

Researcher Signature:  ______________________________ Date: ____________
Sample 3

Sample Informed Consent Form for Interview

Full informed consent with risks, benefits, confidentiality, and participant rights.

INFORMED INTERVIEW CONSENT FORM — SAMPLE

Project: [Study Title]
Researcher: [Name], [Institution], [Email]
Ethics Approval: [Board Name], Reference No. [XXXX]

WHAT THIS STUDY IS ABOUT
[2–3 sentence description of the research topic and why it matters.]

WHAT WILL HAPPEN
You will take part in a recorded interview lasting [duration]. Topics will include
[describe areas]. You may skip any question you prefer not to answer.

RISKS AND BENEFITS
Risks: Minimal. Some questions may touch on sensitive topics. Benefits: None
direct to you; contributes to [field of knowledge].

CONFIDENTIALITY & DATA STORAGE
Your data will be anonymised/pseudonymised. Audio recordings will be transcribed
and deleted within [timeframe]. Transcripts retained for [period] then destroyed.

VOLUNTARY NATURE OF THIS RESEARCH
Participation is voluntary. You may withdraw before, during, or after the
interview. Withdrawal will not affect your relationship with [institution].

INFORMED CONSENT STATEMENT
By signing below, I confirm that:
[ ] I have read and understood the information above
[ ] I have had the opportunity to ask questions
[ ] I agree to participate voluntarily
[ ] I consent to the interview being [audio/video] recorded

Participant Name: _________________________ Date: ___________
Participant Signature: _____________________________________

Researcher Name: _________________________ Date: ___________
Researcher Signature: _____________________________________
Sample 4

Interview Consent Form Example for Journalism

For reporters, press, and media professionals.

JOURNALISM INTERVIEW CONSENT FORM — SAMPLE

Publication / Media Outlet: [Publication Name]
Journalist / Reporter: [Reporter Name]
Contact: [email] | [phone]
Date of Interview: [Date]

─────────────────────────────────────────────────────────

CONSENT TO INTERVIEW

I, [Participant Name], agree to be interviewed by [Reporter Name] on behalf of
[Publication / Media Outlet] on the following terms:

RECORDING
[ ] I consent to this interview being audio recorded
[ ] I consent to this interview being video recorded
[ ] I do not consent to recording; notes only

ATTRIBUTION
[ ] I consent to be quoted by my full name
[ ] I consent to be quoted as [agreed pseudonym/description]
[ ] I wish to speak on background/off the record (as agreed)

USE OF CONTENT
I understand that quotes and information from this interview may be published
in [publication/broadcast], including online editions and social media.

RIGHT TO REVIEW
[ ] I request the opportunity to review relevant quotes before publication
[ ] I do not request review

─────────────────────────────────────────────────────────

Participant Signature: ______________________________ Date: ____________

Journalist Signature:  ______________________________ Date: ____________
Sample 5

UX Interview Consent Form Example

For user research, usability testing, and product design studies.

UX RESEARCH INTERVIEW CONSENT FORM

Company / Team: [Company Name], [Team/Department]
Researcher: [Researcher Name], [Role]
Contact: [email]
Session Date: [Date] | Duration: [Duration]

─────────────────────────────────────────────────────────

ABOUT THIS SESSION
You have been invited to participate in a user research interview. We are
studying how people [use/interact with/perceive] [product/service/prototype].
Your feedback will inform design decisions — your honest opinions are valuable.

WHAT TO EXPECT
This session will last approximately [duration]. We will ask you to [describe,
think aloud, complete tasks, answer questions]. There are no right or wrong answers.

RECORDING & OBSERVATION
[ ] I consent to audio recording
[ ] I consent to video recording (face/screen)
[ ] I consent to screen recording only
[ ] I consent to observers watching the session

DATA USE
Recordings and notes will be used internally for design research only. Data
will not be shared externally or used for marketing.

GDPR / PRIVACY
You have the right to access, correct, or delete your data at any time. Contact
[email] to exercise your rights. Data will be retained for [period].

─────────────────────────────────────────────────────────

Participant Signature: ______________________________ Date: ____________

Researcher Signature:  ______________________________ Date: ____________

How to Adapt These Samples for Your Use Case

Each interview consent form sample above provides a starting point. To adapt them:

  • Replace all bracketed placeholders with your specific information
  • Add or remove sections based on your IRB or ethics committee requirements
  • Adjust the recording consent section to match your actual setup
  • Use plain language appropriate for your participant population
  • Have your institution’s legal or ethics team review before use

Need a specific form type? Browse our full library: research interview consent form, dissertation interview consent form, podcast interview consent form, and more.

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FAQ

Frequently Asked Questions

What is the difference between a sample and a template?
A sample shows you what a completed or near-completed consent form looks like. A template is a blank framework with placeholder text for you to fill in. Both are useful — use the sample as a reference and the template as your working document.
Can I copy the sample text directly?
Yes, these samples are provided as starting points you can adapt. Replace the bracketed placeholder text with your specific details and review with your institution’s ethics or legal team before use.
Are these samples IRB-compliant?
These samples cover the standard elements required by most IRBs. However, IRB requirements vary by institution and country. Always check with your specific IRB before finalizing your consent form.
Can I use these samples for a dissertation?
Yes. The research interview consent form sample is suitable as a starting point for dissertation research. Check your university’s specific requirements and see our dedicated dissertation interview consent form page.