Informed Consent Form for Research

Purpose: This form is used to document informed consent of individuals participating in a clinical trial or scientific research study. It outlines the study procedures, risks, benefits, and the participant's rights.

Participant Information

Full Name: {fullName}

Date of Birth: {dateOfBirth}

Age: {age}

Address: {address}

Email: {email}

Phone Number: {phoneNumber}

Study Overview

Study Title: {studyTitle}

Principal Investigator: {principalInvestigator}

Institution: {institution}

Study Duration: {studyDuration}

Study Purpose: {studyPurpose}

Study Procedures

{studyProcedures}

Risks and Discomforts

{risksDescription}

Potential Benefits

{benefitsDescription}

Compensation and Costs

Will participants receive compensation?

{#hasCompensation}Yes. Participants will receive: {compensationDetails}{/hasCompensation}

{^hasCompensation}No. Participants will not receive compensation.{/hasCompensation}

Will participants bear any costs? {costsToParticipant}

Confidentiality

{confidentialityDescription}

Voluntary Participation and Right to Withdraw

Participation in this study is voluntary. Participants may choose to withdraw at any time without penalty or loss of benefits.

{withdrawalProcedure}

Contact Information

For questions about the study, contact:

• Study Coordinator: {studyCoordinator}
• Phone: {studyPhone}
• Email: {studyEmail}

Additional Notes

{additionalNotes}

Signature and Consent

Procedures Checklist (if applicable)

{#procedureChecklist}

• {procedure}

{/procedureChecklist}

Authorized Persons Who May Access Records