SIMPLE & BASIC — 1 PAGE

Simple Interview Consent Form

A free, simple one-page interview consent form. Basic, plain-language design covering all essential elements — perfect for student projects, small research, and informal journalism.

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PREVIEW
Participant Name
Enter participant name above
Study Title
Enter study title above
Researcher / Interviewer
Enter researcher name above
Institution
Enter institution above
Interview Date
Select date above

PURPOSE: You are invited to participate in a research interview. The purpose is [study title].

VOLUNTARY: Participation is completely voluntary. You may withdraw at any time without penalty.

RECORDING: This interview will be audio and/or video recorded.

CONFIDENTIALITY: All responses will be kept confidential.

PARTICIPANT SIGNATURE: ___________________________   Date: __________

RESEARCHER SIGNATURE: ___________________________   Date: __________

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What to Include

Sample

Simple Interview Consent Form — Sample Text

SIMPLE INTERVIEW CONSENT FORM

Researcher: _________________________ Contact: _______________________
Project Title: ___________________________________________________
Date: ___________________

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

PURPOSE
I am conducting an interview about [topic] for [purpose: my research / a class
project / an article]. The interview will take approximately [duration].

RECORDING
Will this interview be recorded?  [ ] Yes  [ ] No

CONFIDENTIALITY
Your responses will be kept confidential. [Choose: Your name will not be
used / A pseudonym will be used / You will be identified with your consent.]

YOUR RIGHTS
• You do not have to answer any question you are not comfortable with
• You may stop the interview at any time
• Participating is completely voluntary

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

I understand and agree to participate in this interview.

Participant Signature: ______________________ Date: __________

Researcher Signature:  ______________________ Date: __________
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FAQ

Frequently Asked Questions

When should I use a simple consent form instead of a detailed one? ▼
Use a simple consent form for low-risk, informal interviews such as student class projects, simple oral history interviews, and informal journalism. For formal academic research, IRB submissions, or medical research, use a more detailed informed consent form.
What is the minimum a consent form needs to include? ▼
At minimum: who is conducting the interview, what it's for, whether it will be recorded, a basic confidentiality statement, and a voluntary participation statement with a signature line.
Can a simple consent form be handwritten? ▼
Yes. A handwritten consent form is perfectly valid as long as it clearly states the key consent elements and is signed by the participant. Keep a copy for your records.
Is a simple consent form appropriate for classroom research? ▼
Yes. For classroom-based projects and course assignments, a simple one-page consent form is usually sufficient. Check with your instructor for any specific requirements.
Can I adapt this simple form for a journalism interview? ▼
Yes. Add a line for publication name and attribution preferences (on record / off record), and you have a workable journalism consent form. See our journalism interview consent form for a more complete version.