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1) Will the human subjects be informed of the nature of their involvement in the collection of data and of features of the research that reasonably might be expected to influence willingness to participate?

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1)  Will the human subjects be informed of the nature of their involvement in the collection       of data and of features of the research that reasonably might be expected to influence       willingness to participate?                                                                                                  Yes  No 
2)  Will the human subjects be told that they can discontinue their participation at any time?  Yes  No 3)  Will the human subjects in your study be aware that they are the targets of research?     Yes  No 4)  If the subjects are underage, will their guardians be asked to sign the consent form?            Yes  No N/A 5) Is the confidentiality of the human subject’s identity positively ensured? Yes  No 6) In cases where there is a possibility that the human subject`s identity can be deduced by  Yes  No       someone other than the researcher, is the subject`s right to withdraw his/her data       respected? 7) Will the researcher fulfil all the promises made to the human subjects including providing Yes  No        the summary of the findings upon request? 8) Will all necessary measures be taken to protect the physical safety of  Yes  No       the human subjects from dangers such as faulty electrical equipment, poor       grounding, lack of oxygen, falls, traffic & industrial accidents, possibility        of hearing or vision loss etc.? 9) Will the human subject be debriefed (told the true nature of the study) after  Yes  No        the data has been collected? 10) In cases in which the human subject is dissatisfied or a complaint about the researcher or Yes  No       procedure, will the researcher explain to the human subject that he or she may express        this complaint to the Subject Coordinator?  11)  Does the study involve concealment from and/or deception of the human subject? Yes  No 12)  Will deception be used in order to obtain agreement to participate? Yes  No 13)  Will the study involve human subjects who are legally or otherwise not in a position to       give their valid consent to participate such as children, prison inmates, mental patients?  Yes  No 14)  Will information on your human subjects be obtained from third parties? Yes  No 15) Will any coercion be exerted upon subjects to participate? Yes  No 16) Will the study involve physical stress to the human subjects such as might  Yes  No         result from heat, noise, electric shock, pain, sleep loss, deprivation of         food and drink, drugs, alcohol? 17) Will the study cause any mental discomfort to the human subjects such as fear,  Yes  No        anxiety, loss of self-esteem, shame, guilt, embarrassment etc.? 18) Could publication of the research results possibly interfere with strict confidentiality? Yes  No 19) Could publication of the research results possibly harm the human subject -       either directly or through identification with his/her membership group? Yes  No 20) Are there other aspects of the study that may interfere with the protection of the Yes  No       well-being of the human subjects? 


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