Parental Consent Form
This form is for students in Introduction to Psychology at Miami University who have not reached the age of 18 years.
The Department of Psychology at Miami University maintains a Research Experience Requirement as part of its introductory
psychology course (PSY 111). The purpose of this requirement is for course participants to learn about research in the
department as subjects. As examples of the types of research activities going on in the department, participants may be asked
to complete surveys, view and respond to a variety of displays, complete memory tasks or tasks involving activities in virtual
Any student who wishes to serve as a subject in an experiment must sign a written consent form, which is intended to
indicate that the participant understands:
The types of activities in which he/she will engage in the experiment
That his/her participation is voluntary
That he/she has the right at any time to withdraw from the experiment without penalty
A final condition for completing the consent form is that the participant acknowledges that he/she is at least 18 years old.
Because your son/daughter is not currently 18 years old, the Department of Psychology must obtain your written consent to
allow them to participate. This written consent will be kept by the Department of Psychology. At the time of the experiment,
your son/daughter will sign the consent form indicating that they are under the age of 18 years old and have written parental
consent on file with the department.
All of the research in the department has been reviewed and approved by the Miami University Institutional Review Board
(MUIRB), which supervises and oversees all research involving human subjects. Most of the approved research entails what
is commonly referred to as “minimal risk.” This means that in the judgment of the members of the MUIRB, the study does
not pose any significant physical or psychological risks to participants. In the unlikely event that a participant does
experience some discomfort, the researchers are responsible for providing participants with referrals to people or agencies
that can assist them. Such events are extremely rare in research that is approved as minimal risk.
Because your son/daughter is not 18 years old, they must have your consent to participate in research as a subject. In giving
your consent, it is understood that this applies only to research that has been judged as involving minimal risk to participants.
You may also withdraw your consent at any time by calling 513-529-2400 or emailed Dr. Leonard J. Smart
fessor of Psy
y and Chair of t
1. I hereby give my consent for_______________________________________________ to participate as a subject in
ongoing research in the Department of Psychology at Miami University.
2. I understand that I may withdraw my consent at any time and my son/daughter will not be penalized and will be
provided with opportunities to complete the research experience requirement that do not involve research
participation. My son/daughter may withdraw their consent at any time during the experiment without penalty.
3. If you/your child have any questions about your child’s rights as a participant in a research study, he/she may
contact the Miami University Office for the Advancement of Research and Scholarship at 513-529-1757 or email
Your Name_____________________________________________________ Date__________________
Relationship to the above student if not a parent______________________________________________