Consent Form

This service is being conducted by researchers at Duke University to provide more information to the general public on chemical applications in residential furniture. An additional goal of this research is to collect more information on chemical applications in residential furniture over time and within different areas of the United States. Please read this form carefully before consenting to submit a sample and allowing us to collect information on the chemicals in your products.

This service is open to all US citizens 18 years of age or older. If you decide to participate in this study, we will ask you to provide your name and address. We will also ask you to fill out a form with information on the product to be tested, including the type of product, the manufacturer, year purchased (if known), state it was purchased in (if known), and whether the product has a label on it indicating that it meets the California flammability regulation. The names of the manufacturers of these products will not be released in any reports; we retain them only for internal tracking purposes. We will also ask you to sign an acknowledgement that the results we supply are not guaranteed in any way, and that Duke will not substantiate or verify any of the results as part of any consumer litigation. After providing this information, you will be provided with a unique sample ID number that you will attach to your sample before mailing it to our laboratory. This ID number will be linked to the information you provide on the form. The information you enter into the online forms will be downloaded to a password-protected spreadsheet to which only the research team will have access. You will receive your individual test results, but we will not disclose or report your individual test results anywhere. The only information that will be reported on the website are the number of products tested, the types of products tested, and the frequency of detection for different flame retardant chemicals. The online data will be kept indefinitely. Over time, if enough data is collected, we may also publish our generalized findings in a peer-reviewed scientific journal.

The key that connects your name and other identifying information with your unique sample ID number will be stored in a locked filing cabinet and will not be distributed to anyone. The key will be destroyed in five years.

The information gathered will provide both you and us with a better understanding of chemical applications in residential furniture. We do not anticipate any risks to you for participating in this study. If you agree to participate in the study, you may withdraw from the study at any time by sending an email to If you have questions about your rights as a research study participant, you may also contact the Chair of the Human Subjects Committee at Duke University at 919-684-3030 or at

Statement of Consent
"The purpose of this service and study, procedures to be used, risks, and benefits have been explained to me. I have been given the contact information for the person whom I should contact if I have questions or concerns or wish to withdraw from the study. I understand that I can withdraw from the study at any time. I have read this consent form and agree to participate in the study described."

Consent to Legal Terms
I understand that the results provided to me through this service are not guaranteed in any way by Duke University, and I will not use these results as part of any consumer litigation. I understand that the results provided to me are for informational purposes only.