Informed Consent Form for Clinical Trials

Title of Study

Principal Investigator(s)

Institution

Purpose of the Study

Procedures

Risks and Discomforts

Benefits

Confidentiality

Voluntary Participation and Withdrawal

Contact Information

Who to contact for questions about the study: Email: Phone:

Participant Statement

I have read and understood the information provided above. I have had all my questions answered. I voluntarily agree to participate in this study.