Informed Consent Form for Clinical Trial Participants
Title of Study
Principal Investigator
Institution
Contact Information
Purpose of the Study
Procedures
Risks and Discomforts
Benefits
Confidentiality
Voluntary Participation
Withdrawal
Questions or Concerns
Participant's Statement
I have read and understood the information above.
I have had the opportunity to ask questions, and my questions have been answered.
I consent voluntarily to participate in this study.
Participant Name:
Signature:
Date:
Person Obtaining Consent Name:
Signature:
Date: