Creating a Consent Document - Module 3 Section 10s

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Introduction
Background
Procedures
Risks and Benefits
Compensation
Confidentiality
Voluntary
New Information
Contacts and Questions
Consent Statement

You will be given a copy of this form to keep for your records. (This sentence will be inserted automatically into the document.)

Statement of Consent

I have read the above information. I have asked questions and have received answers. I consent to participate in the study. (This sentence will be inserted automatically into the document.)

Click in the square next to the lines you want included in your form.

SIGBOXHERE Signature __________________________ Date _____________

PARENTBOXHERE Signature of Parent or Guardian _______________ Date _______

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