EXAMPLE OF INFORMED CONSENT STATEMENT - University of Kansas知情同意的声明-勘萨斯大学的例子.docVIP

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EXAMPLE OF INFORMED CONSENT STATEMENT - University of Kansas知情同意的声明-勘萨斯大学的例子.doc

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EXAMPLE OF INFORMED CONSENT STATEMENT - University of Kansas知情同意的声明-勘萨斯大学的例子

Items in red are modifications of consent for children Insert HSCL Approval Statement included in approval notification email INFORMED CONSENT STATEMENT _______________________________________________________ (Name of the Study) INTRODUCTION The Department of ___________________ at the University of Kansas supports the practice of protection for human subjects participating in research. The following information is provided for you to decide whether you wish to participate in the present study. You may refuse to sign this form and not participate in this study. You should be aware that even if you agree to participate, you are free to withdraw your child at any time. If you do withdraw from this study, it will not affect your or your child’s relationship with this unit, the services it may provide to you or your child, or the University of Kansas. PURPOSE OF THE STUDY Insert description of the purpose of the study. PROCEDURES Insert description of the procedures that will be followed in the study. Address the participants, i.e. “you will be asked to…” Include the time commitment involved. If you plan to use video or audiotapes, please state so here. Also state what will be done with the tapes, i.e. used by the researchers only and stored in a locked cabinet. RISKS Insert a description of all burdens, inconveniences, pain, discomforts and risks associated with participation in the study. If no risks are anticipated, this should be stated explicitly. BENEFITS Insert a description of the potential benefits, if any, to the research subject. Clarify if these are direct benefits (e.g., to the subject), or indirect benefits, (e.g., to society). If there are no anticipated benefits, this should be stated explicitly. PAYMENT TO PARTICIPANTS Insert a statement regarding whether or not participants will be paid and if so, how much and on what schedule. Include the following statement: Investigators may ask for your social security number in order to comply