Protecting Older Account Holders Focus Groups

INFORMED CONSENT FORM
You are being asked to participate in a research study. This form describes the purpose, procedures, benefits, risks
and precautions of the study. It also describes your right to withdraw from the study at any time. A member of the
study staff is available to read through this form with you and discuss all the information, if you wish.

Why is this study being done?

This study is being done to better understand how consumers use banking as well as other financial services and
what kinds of services and options they would prefer. The study will ask participants to answer questions about their
experiences with different financial products and services.

What do I need to know about this study?

Adults 62 and older are asked to participate in this focus group. Each group will last 60 minutes. The groups will be
audio recorded, but individuals’ names will not be used in any description of findings. In accordance with the
Paperwork Reduction Act of 1995, the questions asked as part of this study have been approved by the Federal
government’s Office of Management and Budget (OMB) under OMB control number 3170-0036. Without this
approval, we could not ask these questions.

What are the potential risks of being in the study?

There are minimal risks associated with this study. Participants will talk about their experiences with bank accounts
and other financial services in small group discussion led by a moderator. Participants do not have to answer any
questions that they do not want to answer.

Does being in this study provide any benefit?

The study will help to improve the experiences consumers have interacting with bank/credit union accounts,
bank/credit union services for seniors, and services/account features that may protect adults aged 62+ from
financial exploitation. Participants in the study will receive $75 in the form of a prepaid Visa gift card for their
participation.

Will it cost me anything to be in this study?

There are no costs to participate in the study, other than possible transportation costs to and from the facility.

Do I have to be in this study?
Participation is voluntary.

Who will have access to this study and/or contact information?

Only the researchers working on this project will have access to the information provided in the study.

Paperwork Reduction Act of 1995:
In accordance with the Paperwork Reduction Act of 1995, this study has been approved by the Federal
government’s Office of Management and Budget (OMB) under control number 3170-0036.
Who do I contact if I have questions about the study?

If you have questions or concerns about the study, you can contact Kinsey Gimbel, Fors Marsh Group,
[email protected], 571-858-3777.

I, _______________________________________, have read this form and agree to participate in this study.
Print Name
_________________________________________________________________________________________
Participant’s Signature
Date
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1010 N. Glebe Road, Suite 510 | Arlington, Virginia 22201 | www.forsmarshgroup.com

Researcher’s Signature

Date

1010 N. Glebe Road, Suite 510 | Arlington, Virginia 22201 | www.forsmarshgroup.com