Informed Consent Form
Vaccine Efficacy Trial
Title of Study:
Principal Investigator:
Institution:
Introduction
Purpose of the Study
Procedures
Potential Risks and Discomforts
Potential Benefits
Confidentiality
Voluntary Participation and Withdrawal
Compensation
Contact Information
Statement of Consent
Participant Name:
Signature:
Date:
Person Obtaining Consent (Name):
Signature:
Date: