Research Study Completion Confirmation Form
Please complete this form to confirm your participation and completion of the research study. All information collected is non-sensitive and used solely for study verification.
Participant Initials
*
Participant Email (for confirmation receipt)
*
example@example.com
Study or Project Reference
*
Assigned Task or Session
*
Study Site or Session Mode
*
Please Select
On-site
Remote/Online
Hybrid
Other
Date of Study Completion
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Completion Status
*
Completed as instructed
Partially completed
Did not complete
Are you eligible for an incentive based on study completion?
*
Yes
No
Not applicable
Comments or Feedback (optional)
I confirm that the information provided above is accurate and that I have completed the research study as described.
*
I confirm
Signature (draw or type your name)
*
Submit Confirmation
Submit Confirmation
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