The Survey Consent Form is a crucial legal document required for any research or survey activity involving human participants in Indonesia. It serves as a formal agreement between the research entity and participants, ensuring compliance with Indonesia's Personal Data Protection Law (Law No. 27 of 2022) and research ethics requirements. This document should be used whenever conducting surveys that collect personal information, whether for academic research, market research, or other professional purposes. The form includes essential information about data collection methods, privacy protections, and participant rights, while incorporating specific Indonesian legal requirements for informed consent and data protection. It's particularly important given Indonesia's enhanced focus on personal data protection and the need for transparent research practices.
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1. Title and Date: Clear identification of the document as a Survey Consent Form with date of issuance
2. Parties: Identification of the research organization/researcher and the participant
3. Background: Brief explanation of the research project and its context
4. Definitions: Key terms used in the consent form
5. Survey Purpose and Procedures: Detailed explanation of what the survey involves and how it will be conducted
6. Participant Rights: Clear explanation of participant's rights including withdrawal, data access, and complaint procedures
7. Data Protection and Privacy: Information about how personal data will be collected, stored, used, and protected in compliance with Indonesian PDP Law
8. Risks and Benefits: Description of any potential risks and benefits of participation
9. Time Commitment: Expected duration of participation
10. Consent Declaration: Formal statement of consent and signature section
1. Compensation: Details of any payment or compensation offered (include if participants will receive compensation)
2. Medical Disclaimer: Required if the survey involves health-related questions or medical information
3. Third Party Data Sharing: Include if data will be shared with other organizations or researchers
4. Recording Consent: Required if the survey involves audio or video recording
5. Parent/Guardian Consent: Required if participants are minors or legally incompetent persons
6. Translation Declaration: Required if the form is provided in multiple languages
1. Survey Questions Preview: Sample or full list of survey questions to be asked
2. Data Processing Information: Detailed information about data processing procedures and security measures
3. Contact Information Sheet: Complete contact details for researchers, ethics committee, and data protection officer
4. Withdrawal Form: Template form for participants to withdraw from the study
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