Vulnerable Populations Research
Informed Consent Waiver Form

Study Title Principal Investigator Department / Affiliation

Waiver Request Justification

Provide a detailed justification for the request to waive informed consent for this research involving vulnerable populations.

Briefly describe the purpose, procedures, and targeted vulnerable population(s).

Describe the risks (if any) to participants and how they will be minimized.

Outline how participant privacy and data confidentiality will be maintained.

Add any other information pertinent to this waiver request.

I confirm that the information provided in this form is accurate and complete to the best of my knowledge.

Principal Investigator Signature

Date