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Informed Consent Form

Informed Consent Form

It is a best practice to obtain informed consent from usability test participants to ensure they know how the data that is collected will be used and to set their expectations for what will happen during the test. This form may be tailored to your needs, but is a good starting point.

We are gathering your opinions of a product. We would like to conduct a usability test with you to learn about how you use this product. The usability test should take 30 minutes or less of your time. We are collecting this information as part of an assignment for “UX Research at Scale: Surveys, Analytics, and Online Experiments”, a class that is of the Coursera/University of Michigan Specialization program.

You are not required to participate in this and you may skip questions or stop at any point in the interaction.

The data we collect is not identified with you personally. We report opinions and demographics in the aggregate and keep the data anonymous.

We will collect your name at the outset along with contact information if we have any follow-up questions, but the identifying information will be destroyed at the end of the semester.

We may be collection audio and video recordings of the usability test or interview afterwards so that we can check back with some facts in case we miss them in our note-taking. Like the identifying information, the recordings will be destroyed at the end of the semester.

If you have any questions please contact us at:


I agree to participate in this assignment and be audio recorded.

Signed: Date:

Print your name:

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UX Research at Scale: Surveys, Analytics, Online Testing

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