Clinical Trial Data Privacy Consent Form
Participant Information
Full Name
Date of Birth
Email Address
Purpose of Data Collection
Types of Data Collected
How Your Data Will Be Used
Your Rights
Right to withdraw consent at any time
Right to access and correct your data
Right to request deletion of your data
Right to contact the study team with questions or concerns
Voluntary Participation
Contact Information
I have read and understood the information above and voluntarily consent to the collection and use of my data in this clinical trial.
Signature
Date