Appendix F - Verbal Consent for Remote Interviews

Appendix F Verbal Consent for Remote Interview Final.docx

Cognitive and Psychological Research

Appendix F - Verbal Consent for Remote Interviews

OMB: 1220-0141

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Appendix F: Remote testing verbal consent

Upon beginning a remote testing session, participants will be shown and told the following information and asked for their verbal consent prior to beginning the study:


  • We are conducting research to increase the quality of BLS surveys


  • We estimate the session will last about 60 minutes.


  • Your participation in this research project is voluntary, and you have the right to stop at any time.

  • We will not share your personal information in identifiable form with anyone beyond the BLS staff involved in this research.


  • Showcard on screen:


The OMB control number for this information collection is 1220-0141 and expires March 31, 2021. Without this approved OMB number, BLS would not be able to conduct this survey.


The BLS, its employees, agents, and partner statistical agencies, will use the information you provide for statistical purposes only and will hold the information in confidence to the full extent permitted by law. In accordance with the Confidential Information Protection and Statistical Efficiency Act (44 U.S.C. 3572) and other applicable Federal laws, your responses will not be disclosed in identifiable form without your informed consent. Per the Federal Cybersecurity Enhancement Act of 2015, Federal information systems are protected from malicious activities through cybersecurity screening of transmitted data. The Privacy Act notice on the back of this form describes the conditions under which information related to this study will be used by BLS employees and agents.


In accordance with the Privacy Act of 1974 as amended (5 U.S.C. 552a), this study is being conducted by the U.S. Department of Labor, Bureau of Labor Statistics (BLS), under the authority of 29 U.S.C. 2.  Your voluntary participation is important to the success of this study and will enable the BLS to better understand the behavioral and psychological processes of individuals, as they reflect on the accuracy of BLS information collections.  The information will only be used by and disclosed to BLS personnel and contractors who need the information for activities related to improving BLS information collection.  Information on routine uses can be found in the system of records notice,  DOL/BLS – 14, BLS Behavioral Science Research Laboratory Project Files (81 FR 47418). 


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