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Survey Consent & Demographics

A reusable consent-and-demographics block for the start of any study.

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4 questions

Single choice

1. Do you agree to participate in this anonymous research study?

  • I agree
  • I do not agree
Required
Number

2. Age

Single choice

3. What region do you currently reside in?

  • North America
  • South America
  • Europe
  • Asia
  • Africa
  • Oceania
  • Other
Multiple choice

4. Which of the following best describes your occupation?

  • Student
  • Employed full-time
  • Employed part-time
  • Self-employed
  • Unemployed
  • Retired
Use this template

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