Consent To Participate In Research printable pdf download

Consent To Participate In Research

Consent to Participate in Research

You are being asked to participate in a research study.

Before you agree, the investigator must tell you about (i) the purposes, procedures, and

duration of the research; (ii) any procedures which are experimental; (iii) any reasonably

foreseeable risks, discomforts, and benefits of the research; (iv) any potentially beneficial

alternative procedures or treatments; and (v) how confidentiality will be maintained.

Where applicable, the investigator must also tell you about (i) any available

compensation or medical treatment if injury occurs; (ii) the possibility of unforeseeable

risks; (iii) circumstances when the investigator may halt your participation; (iv) any

added costs to you; (v) what happens if you decide to stop participating; (vi) when you

will be told about new findings which may affect your willingness to participate; and (vii)

how many people will be in the study.

If you agree to participate, you must be given a signed copy of this document and a

written summary of the research.

You may contact ___________________________ phone number__________________

any time you have questions about the research.

You may contact ___________________________ phone number__________________

if you have questions about your rights as a research subject or what to do if you are

injured.

Your participation in this research is voluntary, and you will not be penalized or lose

benefits if you refuse to participate or decide to stop.

Signing this document means that the research study, including the above information,

has been described to you orally, and that you voluntarily agree to participate.

_____________________________

____________

Signature of participant

date

_____________________________

____________

Signature of witness

date

Short Form Consent - ENGLISH

Consent To Participate In Research