| Instructions and Forms/Templates |
Instructions
6/07
|
Instructions for the preparation
of research consent forms. Refer to Alternative
Lay Language for Medical Terms for a glossary
that gives alternative lay language for medical
terms.
|
Informed
Consent Document Checklist
5/07 |
Checklist
for the preparation of research consent
forms. |
|
General Consent Form Template
11/05
Spanish
Consent Form Template
11/05
|
Consent
form template for use when the study plan is to
enroll only adults or both adults
and children. When children age 14-17
are to be enrolled, consent of the parent and
assent of the child are documented on this form.
When children age 13 or less are to be enrolled,
consent of the parent is documented on this form
and assent of the child (age 7-13) is documented
on the separate Youth
Assent Form.
|
Parental
Consent Form Template
11/05
|
Consent
form template for use when the study plan is to
enroll only children. When children
age 14-17 are to be enrolled, consent of the parent
and assent of the child are documented on this
form. When children age 13 or less are to be enrolled,
consent of the parent is documented on this form
and assent of the child (age 7-13) is documented
on the separate Youth
Assent Form.
|
|
Youth
Assent Form
8/98
|
Assent
form for use when the study plan is to enroll
children age 7-13. When children age 14-17 are
to be enrolled, assent of the child is documented
on the General or Parental Consent Form template
(see instructions above).
|
| Blood
Draw Consent Form (No PHI)
8/07
|
Consent form template for studies limited to blood
collection where no identifiable health information
will be linked by use of a code or other means
to the blood sample. Refer to research with de-identified information
for more information.
|
Blood
Draw Consent Form (PHI)
8/07 |
Consent and authorization template for studies
limited to blood collection and the use of identifiable
health information. Refer to the PHRC HIPAA page for more information
|
Tissue
Repository Consent Form
11/05 |
Consent
form template for studies that involve banking
specimens/samples for future use and/or distribution
to multiple investigators. For more information,
see sample Research
Consent Form.
|
| Consent
Form and Authorization for Studies with a Certificate
of Confidentiality
5/07
Parental
Consent Form and Authorization for Studies with
a Certificate of Confidentiality
9/07
Spanish
Consent Form and Authorization for Studies with
a Certificate of Confidentiality
4/03
|
Consent form template for studies for which a Certificate
of Confidentiality has been obtained.
|
|
"Short Form" Consent Documents
in Other Languages
|
Short form consent documents written in Arabic,
Chinese, Italian, Portuguese, Russian, Spanish
and Vietnamese. Requires Adobe Acrobat. Refer
to policy for Obtaining and Documenting Informed
Consent of Subjects Who Do Not Speak English |
