Consent forms for usability interviews

Usability Interviews With Adults

Consent Form

Name of Usability Test—e.g., Usability

Evaluation of the Online Form for

Coverage Followup (CFU)

Each year the Census Bureau conducts many different usability evaluations. For example, the Census Bureau routinely tests the wording, layout and behavior of products, such as Web sites and online surveys, in order to obtain the best information possible.

You have volunteered to take part in a study to improve the usability of [name of survey—e.g., the online form for Coverage Followup]. In order to have a complete record of your comments, your usability session will be videotaped. We plan to use the tapes to improve the design of the product. Staff directly involved in the usable design research project will have access to the tapes. Your participation is voluntary and your answers will remain strictly confidential.

This usability study is being conducted under the authority of Title 13 USC. The OMB control number for this study is 0607-0725. This valid approval number legally certifies this information collection.

I have volunteered to participate in this Census Bureau usability study, and I give permission for my tapes to be used for the purposes stated above.

_________________________________ ___________________________

Parent's Signature Researcher's Signature

__________________________________ __________________________

Printed Name Printed Name Printed Name Printed Name

________________________________________________________________

Date Date

Usability Interviews With Minors

Consent Form

Usability of Web site — e.g.,

Census in the Schools

Kids’ Page

Each year the Census Bureau conducts many different usability studies of its public Web sites. For example, the Census Bureau routinely tests the wording, layout and behavior of online sites in order to provide the best possible experience for visitors.

______________________[CHILD’S NAME] has my permission to take part in a study to improve the design of [name of Web site—e.g., Kids’ Page for Census in the Schools]. In order to have a complete record of your child’s comments, his/her usability session will be videotaped. We plan to use the tapes to improve the design of the Web site. Staff directly involved in the research project will have access to the tapes. Your child’s participation is voluntary, and his/her comments will remain strictly confidential.

This study is being conducted under the authority of Title 13 USC. The OMB control number for this study is 0607-0725. This valid approval number legally certifies this information collection.

I have agreed to allow my child to participate in this Census Bureau Web site design study, and I give permission for his/her tapes to be used for the purposes stated above.

_________________________________ ___________________________

Parent's Signature Researcher's Signature

__________________________________ __________________________

Printed Name Printed Name Printed Name Printed Name

________________________________________________________________

Date Date