Informed Consent Form for Clinical Trial Participants
Study Title
Investigator(s)
Institution
PURPOSE OF THE STUDY
PROCEDURES
POTENTIAL RISKS AND DISCOMFORTS
POTENTIAL BENEFITS
CONFIDENTIALITY
VOLUNTARY PARTICIPATION
CONTACT INFORMATION
PARTICIPANT STATEMENT
I have read and understood the information provided above.
I have had the opportunity to ask questions and have received satisfactory answers.
I voluntarily agree to participate in this clinical trial.
Participant's Name
Signature
Date
Investigator's Name
Signature
Date