Message
All templatesEducation & Academic
Research Participant Eligibility & Informed Consent Screener
Screens prospective research participants for eligibility and verifies comprehension of informed consent elements before enrollment in an academic study.
No sign-up to try · Unlimited responses on the free plan
Live preview
Research Participant Eligibility & Informed Consent Screener
Welcome to this research screening. Over the next few minutes we will confirm your eligibility and ensure you understand the study before you decide whether to participate. There are no right or wrong answers. Your responses are confidential and will be reported only in aggregate.
Powered by QuestionPunk
Default theme. Colors and fonts are yours to change.
Sample questions
A preview of what’s in the template. Every question is editable before you launch.
10 questions · ~4 min
Q01
Multiple Choice
Are you 18 years of age or older?
- Yes, I am 18 or older
- No, I am under 18
Message
About this study: • Purpose: You will answer short questions about your attitudes and experiences. • Duration: Approximately 5–10 minutes. • Risks: Minimal. Some questions may cause mild discomfort. You may skip any question you prefer not to answer. • Withdrawal: Participation is entirely voluntary. You may stop at any time without penalty or loss of compensation. • Privacy: Responses are collected without direct identifiers, stored securely, and analyzed only in aggregate. • Contact: If you have questions, please reach the research team listed in the study posting.
Q02
Multiple Choice
Based on the information above, which of the following best describes your rights as a participant?
- Participation is voluntary, and I may withdraw at any time without penalty.
- I may withdraw, but only before answering the first question.
- I must complete the full survey to receive any compensation.
- My individual responses will be shared with third parties.
Q03
Multiple Choice
Do you consent to participate in this study under the terms described above?
- Yes, I agree to participate.
- No, I do not agree to participate.
Q04
Multiple Choice
In the past 12 months, have you participated in any academic research studies?
- Yes
- No
- Not sure
Q05
Dropdown
What is your age group?
- 18–24
- 25–34
- 35–44
- 45–54
- 55–64
- 65 or older
- Prefer not to say
Q06
Multiple Choice
What is your gender?
- Woman
- Man
- Non-binary
- Prefer to self-describe
- Prefer not to say
Q07
Dropdown
What is the highest level of education you have completed?
- Less than high school
- High school or equivalent
- Some college
- Associate degree
- Bachelor's degree
- Master's degree
- Doctorate or professional degree
- Prefer not to say
Q08
Multiple Choice
What is your current employment status?
- Employed full-time
- Employed part-time
- Self-employed
- Student
- Homemaker/Caregiver
- Unemployed
- Retired
- Prefer not to say
Q09
Dropdown
In which region do you currently reside?
- North America
- Latin America/Caribbean
- Europe
- Middle East/North Africa
- Sub-Saharan Africa
- East Asia
- South Asia
- Southeast Asia
- Oceania
- Prefer not to say
Q10
Long Text
Do you have any questions or concerns about the study information provided above? If so, please share them here.
Message
Thank you for completing this screening. If you were eligible and consented, you will now proceed to the main study. If not, no further action is needed. We appreciate your time.
What’s included
AI follow-ups
Adaptive probes on open-ended answers that pull out detail a static form would miss.
Attention checks
Built-in safeguards against rushed answers and low-quality respondents.
AI-drafted copy
Wording, ordering, and branching written by the AI — tuned to your research goal.
Auto report
Themes, quotes, and a plain-English summary write themselves once responses come in.
How it compares
We reviewed the closest templates from other survey tools. Here’s what they do well — and where this template goes further.
Why this template
- Combines an actual eligibility gate (age check) with a plain-language study summary before asking for consent, rather than presenting consent as a single static document
- Includes a comprehension check question ('which of the following best describes your rights') that verifies the participant understood the consent terms, not just that they clicked agree
- Layers in standard screening demographics (age group, gender, education, employment, region, prior research participation) so eligibility and quality screening happen in one flow
- Provides an open-text field for questions or concerns before enrollment, with automated per-response quality scoring and a generated report for the researcher
Jotform
Research Informed Consent Form TemplateA static, fillable consent form template aimed at capturing signed consent for academic/research studies, similar in purpose to our screener's consent section. It's built for form completion and e-signature capture rather than for verifying comprehension or screening eligibility conversationally. Best suited for teams that only need a documented consent record, not a full participant intake/eligibility flow.
What it does well
- Purpose-built for research consent documentation, likely with e-signature support
- Simple, familiar Jotform builder for quick customization and deployment
- Likely integrates with Jotform's broader form ecosystem (notifications, storage)
Where it falls short
- Static form with fixed questions — no adaptive AI follow-up to probe unclear or concerning answers
- No built-in comprehension check or automated scoring of whether a participant actually understood consent terms
- No voice AI interview option or automated eligibility report generation
Frequently asked questions
What questions are in the “Research Participant Eligibility & Informed Consent Screener” template?
The template includes 10 ready-to-use questions, starting with: “Are you 18 years of age or older?” · “Based on the information above, which of the following best describes your rights as a participant?” · “Do you consent to participate in this study under the terms described above?”. The full set is previewed above, and every question is editable.
How long does this survey take to complete?
Respondents typically finish the 10 questions in about 4 minutes.
Can I customize this template?
Yes — every question, answer option, and the ordering is editable before you launch. You can add or remove questions, or ask the AI editor to rework the survey around your research goal.
Is this template free to use?
Yes. Open it in the editor and start customizing right away — no account required to try it, and the free plan covers launching your survey.
Ready to launch?
Open this template in the editor. Every part is yours to change before the first respondent sees it.
Related templates
More studies on similar topics.
