Research Participant Consent, Confidentiality and Non-Disclosure Agreement

The research study in which you are about to participate will cover confidential information that is protected by law.

This agreement sets forth the terms and conditions under which protected information may be used and disclosed during the research study you are attending. 

This agreement shall commence on the date of your research study (today) and shall continue indefinitely.


  1. The research participant hereby agrees to maintain the security and privacy of all confidential personal and corporate information by keeping the content of such information completely confidential and complying with all state and federal laws and regulations, including the HIPAA and regulations thereunder, and all applicable law.
  2. The research participant further agrees not to use or disclose any information presented during the discussion to any third parties and to only use the information presented to the extent necessary to serve as a research participant.
  3. Upon conclusion of the research study, the research participant shall return all disclosed handouts, notes, and discussion materials disclosed and released during the project to research staff and shall retain no copies of such information. Such information is strictly confidential.
  4. The research participant agrees to be in good health and will comply with any requests by staff, researchers, and participants to use sanitizer, cover coughs, wear face masks if asked, and ensure the health of all others involved.

I understand that the information, materials, and documents that I will be given during this project are strictly confidential and cannot be discussed at any time outside this research exercise. I understand that sharing the details of my experience in any way is strictly confidential and is considered a breach of this contract.

I understand that my responses and discussions at the focus group today will be recorded for later analysis. Any recordings will be used for private research purposes only, are protected under privacy law, and are not for public distribution.