We ask that you read this document and ask any questions you may have
before agreeing to be in the study.
Risks and Benefits of Being in the Study:
The study has the following risks: RISKSHERE
Voluntary Nature of the Study
Contacts and Questions
You may ask any questions you have now.
You will be given a copy of this form to keep for your records.
Statement of Consent:
I have read the above information. I have asked questions and have
received answers. I consent to participate in the study.
Signature of Participant ________________________ Date ___________
THIS PROJECT HAS BEEN REVIEWED BY THE CALIFORNIA STATE UNIVERSITY, LOS ANGELES
INSTITUTIONAL REVIEW BOARD FOR THE PROTECTION OF HUMAN SUBJECTS IN RESEARCH
(Phone number: 323-343-5366)