Thank you for taking the time to speak with us about [brief study overview]. This research is being conducted by [agency], (which is a part of the Executive Office or other parent agency TO FILL IN)). 

Participation guidelines 

• Please read the information carefully.  

• Your participation is voluntary.  

• You must be: 

• At least 18 years old 

• Within the United States during your interview  

• Complete this form if you agree to being interviewed.  

If you have any questions or would like a copy of this form for your records, email [email address]. 

How we’ll use the information you share with us 

• Recommend improvements to teams working on [X  process/product/service TO BE FILLED IN BY AGENCY] 

• Present to government agencies, employees, contractors, and vendors. 

Participating in the interview is completely voluntary and up to you.    

• You don't have to answer any question for any reason.     

• You can ask us to stop, take a break, or leave the interview at any time without giving a reason.     

• You can ask us not to use any or all of your interview, even after we are done. Email [email address] to do so.    

• You can choose not to turn on your video camera before the recording has started and can turn it off at any time.  

• What you share with us will not affect any applications or benefits you may have or receive from the state.    

• You will receive [compensation amount] for participating (only if recruiting participants outside of platforms which compensate participants).  
  Note: If you are a public employee, you are not eligible for compensation.  

We will keep your information secure.  

• We will never use your name or other personally identifiable information in any materials related to this research study unless we are required to do so by law. 

• What you share may be accessed by government employees, contractors, and external vendors working with the Commonwealth of Massachusetts to improve government products and services. 

• All information and related forms of data we collect will be securely stored to inform future studies as applicable. This information and data will be disposed of as required by the Massachusetts Standards for Disposal of Information and the Massachusetts Records Retention Schedule.  

• If we are legally required to disclose any data, we will remove your personal information as allowed by law. For more information, review the public records law (MA General Law. chapter 66, § 10 and M.G.L. chapter 4, section 7, clause 26) and the Secretary of the Commonwealth of Massachusetts’ website.   

Participation Acknowledgement and Recording Consent 

I confirm that:     

• I am 18 years of age or older. 

• I’ve read and understood the participation guidelines and data privacy statements. 
• Participating in this research will not affect any applications or benefits I may have or receive from the Commonwealth of Massachusetts. 

By signing you agree with the Participation guidelines and give your permission to the record according to the items you selected in the Recording Consent section of this form. You also give permission for researchers from [agency] to store the personal data you share with us, including your name and email address.