UX/CX Research Participant Consent Form
For User Experience, Interface, and Customer Research
This form ensures transparency between you (the participant) and our research team. It outlines what the session involves, how your data will be handled, and your rights. Please review it carefully before giving consent.
⚠️ Note: This is a reference template. Please consult legal/compliance advisors before using in production environments.
🔍 Study Details
Project Title: [Insert Research Title]Researcher/Company: [Insert Name or Team]Date: [Insert Date]
🎯 Purpose
We're conducting this study to better understand how users interact with [describe product/tool/feature]. Your feedback will help us improve the experience and identify areas that need refinement.
This session is not a test of your skills — it’s about the product, not the person.
🧪 What You’ll Be Asked to Do
You may be invited to:
Use a digital interface or product prototype
Complete specific tasks or scenarios
Answer open-ended questions or give feedback
Participate in a survey or interview
Estimated Duration: [Insert time estimate]Breaks are available anytime — just let us know.
🎥 Observation & Recording
With your permission, we may record the session (e.g., screen, voice, or camera) to support our analysis. These materials are for internal research use only and will not be shared externally.
I agree to being observed and recorded
I do not agree to being recorded
🔐 Data & Privacy
Your responses will be stored securely for up to [X months/years]
Any personal identifiers will be removed or anonymized before analysis
Data is used strictly for research and internal improvement
We follow [Company]'s privacy and security standards
I consent to my data being collected and stored
I do not consent to my data being stored
🤝 Confidentiality
Your identity and responses will remain confidential.Please do not share study details outside this session. (Separate NDAs may apply if relevant.)
🙋 Voluntary Participation
Participation is 100% optional. You may decline or exit at any time — no questions asked, no consequences.
⚖️ Risks & Benefits
There are no known risks from participating. You may benefit by:
Helping shape better product experiences
Receiving [compensation, if any]
Supporting user-centered design practices
If you have any special medical or personal considerations (e.g., epilepsy, PTSD, pregnancy), please let us know.
🎁 Compensation
[Insert details here — e.g., “You’ll receive a $25 gift card after completing the session.”]
❓ Questions or Concerns
Reach out anytime if you have questions or want to opt out.
Contact: [Name]Email: [email@example.com]Phone: [XXX-XXX-XXXX]
✍️ Your Consent
By signing below, you confirm that:
You’ve read and understood the above information
You’re participating voluntarily
Your questions (if any) have been answered
Participant Name: ____________________________Signature: ____________________________Date: ____________________________