Neuroscience Study Consent Form

Study Title

Principal Investigator

Purpose of the Study

Procedures

Duration

Risks and Discomforts

Benefits

Confidentiality

Voluntary Participation and Withdrawal

Contact Information

Principal Investigator:
Email:
Phone:
For questions about your rights as a participant, contact:

Consent

I have read and understand the information above. I voluntarily agree to participate in this study.

I am 18 years of age or older.

Participant Name

Date

Participant Signature

Researcher Name

Date

Researcher Signature