A note on language
The template itself is in Spanish, and the statute it is contrasted against is Chilean. This page explains what it contains and why it is built the way it is, so you can judge whether the structure travels to your jurisdiction. The structure does: what to tell someone, what to ask separately, what to put in writing. The specific law does not.
When to use it
Before any session where you will record a person, store what they say, or show it to a third party. Interviews, usability tests, field studies, remote or in person.
If your study touches sensitive data — physical or mental health, sexual life, racial origin, beliefs, political opinions — or involves minors, this template falls short and someone with legal training should look at it.
Before you use it
Everything in brackets gets replaced. If a block does not apply — you are not recording video, say — delete it entirely rather than leaving it greyed out: a consent form that mentions things that will not happen is confusing, and a confusing consent form is not consent.
Two decisions I made, in case you want to change them:
The authorizations are separate. Taking part, being recorded, and having a clip used in a presentation are three different things, and someone can want the first without the other two. Bundled into one checkbox, what gets signed is a formality. Splitting them costs three lines and changes the conversation.
It is written to be understood on the first read. No "the participant hereby declares", no third person. If someone needs to read it twice, the template failed.
This is not legal advice. It is the structure I use on my own projects, contrasted against what Chile's Law 19.628 requires.
The document
This is the only part the participant sees. Everything else on this page is context for you, and does not travel in the download.
{/* --- INICIO DOCUMENTO --- */}
Study: [study name] Responsible: [organization or person] Contact: [name, email] Date: [session date]
Who we are and what we are doing
We are [organization] and we are running a study to [objective in one plain sentence: understand how people use X, find out what makes Y hard].
We are not evaluating you. We are evaluating [the product, the service, the process]. If something is unclear or does not work, that is useful information for us, not a mistake on your part.
What we will ask of you
The session lasts about [X] minutes and is [remote by video call / in person at (place)]. During that time we will [talk about your experience with X / ask you to use (product) while telling us what you are thinking / show you some material and ask your opinion].
You do not need to prepare anything.
Recording
With your authorization, we will record [audio / audio and video / the screen]. The recording lets us review what you said afterwards without depending on what we manage to write down at the time.
If you would rather we did not record, the session happens anyway and we take notes.
What we do with what you tell us
We analyze all the sessions together and write a report of what we found. That report is read by [the X team / our client, (name, or "a company in the Y sector" if there is a confidentiality agreement)].
The report may quote you verbatim, without your name and without details that would make you recognizable. That includes things like your job title next to your company's name, which often identify a person even with no name attached. Instead of your name we use something like "Participant 3".
[If applicable] We may also use a short video clip in an internal presentation to the team. You authorize that separately below, and you can say no without changing anything else.
Taking part is voluntary
Answering is optional: you can skip any question, ask us to pause, or end the session at any point. You do not have to explain why.
If you later want to withdraw your authorization, write to [email]. What we already analyzed before that point cannot always be undone, but we stop using your material from then on.
[If there is an incentive] The [amount / description] incentive is yours regardless, even if you decide to stop early.
Your data
We store: [list the concrete items: your name and email to arrange the session, the recording, our notes].
Who has access: only [the research team at (organization)]. The files live in [where: a restricted-access drive].
For how long: we keep recordings [X months] and then delete them. The report carries nothing that identifies you.
Your rights
You can ask us at any time what information we hold about you, to correct it if it is wrong, or to delete it. Write to [contact email] and we reply within [timeframe].
Questions
Any question about the study, before or after: [name, email, phone if relevant].
Authorizations
Tick what you authorize. You can tick some and not others.
- I agree to take part in this session.
- I authorize recording [audio / audio and video / the screen] of the session.
- I authorize quoting me verbatim, without my name, in the study report.
- [If applicable] I authorize using a short video clip in internal team presentations.
I read this document, I understood what it is about, and I was able to ask questions.
Name: __________________________
Signature: __________________________
Date: __________________________
{/* --- FIN DOCUMENTO --- */}
Verbal script for remote sessions
In remote sessions nobody signs anything, and that is exactly when consent gets skipped.
This script does not replace the written authorization. Article 4 of Law 19.628 says, verbatim, that "the authorization must be recorded in writing", so in Chile the spoken version is not enough on its own. What works is sending the document by email or form beforehand, getting it back completed, and reading this script at the start anyway: the written part satisfies the law, the spoken part is what makes the person actually understand what they said yes to.
You read it after pressing record, not before.
"Before we start I want to tell you how this is going to work and ask your permission for a couple of things.
We are [organization] and we are running a study to [objective]. The idea is to understand [X]. We are not evaluating you, we are evaluating [the product].
This takes about [X] minutes. I have already started recording [audio and video / the screen], and only we use the recording, to review afterwards. We keep it [X months] and then delete it.
What you tell me goes into a report read by [whom]. If I quote something you say, it goes without your name.
You can skip a question, ask me to stop, or cut this short whenever you want. [If there is an incentive: the incentive reaches you regardless.]
Are you okay with taking part and with us recording?
[Wait for an explicit answer. If yes, continue. If they hesitate, ask what worries them before going on.]
Any questions before we start?"
Two things I learned about reading it: you have to wait for an audible "yes", because silence or a nod is worth nothing when you review the recording later; and you have to make a real pause at "any questions?". If you read straight through, the person understands that this is not the moment to ask.
Check before using it
- Any bracket left unreplaced?
- Are the blocks that do not apply deleted rather than just emptied?
- Is the study objective in one sentence someone can follow without knowing research?
- Is the recording retention period one you will actually honour?
- Does the contact person exist and read that inbox?
- Did someone outside the team read it and understand it first time?
Grounding
I verified this against the text of the law at the National Congress Library on 6 September 2026.
Until 30 November 2026, Law 19.628 on the protection of private life is in force in Chile. Three articles bear directly on research work:
- Article 3. Explicitly names "surveys, market studies or public opinion polls or other similar instruments", and requires informing people "whether answering is mandatory or optional, and the purpose for which the information is being requested". Also: the communication of results "must omit the marks that could allow the identification of the persons consulted" — marks, not just names.
- Article 4. Processing requires that "the data subject expressly consents", and "the authorization must be recorded in writing". So does revocation, and it is "without retroactive effect": that backs the caveat about findings already folded into the analysis.
- Article 7. People who work with personal data are bound to secrecy, and that duty "does not cease upon having ended their activities in that field".
Article 2(g) defines sensitive data: personal habits, racial origin, political ideologies and opinions, religious beliefs, physical or mental health, and sexual life.
From 1 December 2026, Law 21.719 takes over, replacing much of that framework and creating a data protection agency. I did not read its text article by article: if you are reading this after that date, this section needs redoing.
If you have participants in the European Union, GDPR applies on top and asks for more than this template covers: an explicit legal basis, an identified processor, and the right to portability.
None of this is legal advice, and it does not replace reviewing your own case with someone qualified.