Sample Assent Form (PLEASE ADAPT TO YOUR PROJECT PROPOSAL; please be aware that the language used in the assent form will need to be appropriate to the age of minor you will be including; as shown below, this would be for an older, at least teenage, child. A small child would need very simple language and understanding that no one is going to be mad at them if they do not participate. There are many examples online of sample assent forms for children of all ages and you are encouraged to adapt appropriate forms as needed. Note also that it is acceptable to obtain oral assent from non-literate study participants, but records of when, how, where, and who collected the oral consent must be made).

Minimum Information that should be included in a consent form:

• explanation of purposes of research
• expected duration of subject’s participation
• description of procedures
• identification of any procedures that are experimental
• description of any foreseeable risks or discomforts
• description of steps taken to ensure confidentiality
• explanation of whom to contact for answers to any questions
• statement that participation is voluntary, that subjects can withdraw without penalty at any time
• opportunity for child to say “no” even if parent has said “yes.”

Would you like a printable version? Feel free to download a printable version of this Sample Assent Form (Word Doc 16KB).

Microsoft Word

Please note that this document is in Word format. Don’t have Word on your computer or laptop? Not to worry! All K College students, faculty, and staff may use their Office 365 accounts to edit this document. For further information on accessing Office 365, visit the Information Services page on Office 365.