Eastern Connecticut State University
Eastern Surveys
A CIT Service

Page 1 of 1
  Consent Form: Conflict, Jealousy, and Love in Relationships

To participate you must be:
• At least 18 years old
• A man

This research project seeks to better understand conflict in relationships and how this is related to jealousy, love, commitment, and the need for independence in a relationship. You will complete a series of questionnaires about a romantic partner.

• You will be participating in a research project.
• You must be 18 years old in order to legally participate in this research project.
• Your participation in this project is completely voluntary.
• All information collected will be completely anonymous. This means that there is no way your identity can be linked to your data.
• By signing this consent form, you are not waiving any of your legal rights, and you may cease participation at any time without penalty.
• The questionnaire will take approximately 1 hour to complete.
• You will complete a questionnaire about both positive and conflictual aspects of a romantic relationship.
• There are no physical risks to participating in this study; there are minimal psychological risks in participating in this study.
• If anything in the study offends you in any way, you are encouraged to cease your participation; there will be no penalty for doing so.
• There will also be no penalty if you do not wish to complete any part of this study.
• The researcher cannot share individual results with you, although upon request, the researcher would be more than happy to provide a summary of the overall results.
• This research has been approved by the IRB at Eastern Connecticut State University.
• If you want to receive credit for participation in this survey, after completing the survey you will be prompted to give your email address. A copy of the debriefing form will be sent to your email. Your email address will not be stored with the data.

In the event that you need to contact someone regarding the study, you may feel free to contact:
Dr. Alita Cousins
Psychology Department
Eastern Connecticut State University
Willimantic, CT 06226

This research has been approved by the ECSU Committee on the Use of Human Subjects (IRB Protocol #1828). If you have questions about your rights as a research participant, you may contact:
Dr. Charles Booth, Chair of the ECSU Committee on the Use of Human Subjects in Research Phone: 860-465-5260
Email: booth@easternct.edu

 Cancel  Save  Done