These samples may help investigators draft their study-specific consent forms. Please be aware that these templates may not be appropriate for all settings. (See *below for minimal risk research.) Please contact the IRB Office for guidance about developing consent forms that are appropriate to your study population.
Q & A Consent Template for Clinical Trials - FDA Studies - Revised March 2015. Appropriate for FDA-regulated studies, this template is written in a Question and Answer format.
Consent Form Template 2 - Revised 6-23-2008. This template should be used for internal studies and for other projects where all data released to external parties has been de-identified according to HIPAA standards.
Consent Template Parental Permission - Revised 5-18-2009
Consent Template Child Assent Examples - Revised 1-26-2009
Consent Template for Surrogate Decision-Makers - Revised 7-2-2009. This template is appropriate for persons who are consenting to research on behalf of another adult who does not have decisional capacity.
Consent Template for Emergency Use - 11-11/2014
Consent Template for Pregnant Participant / Partner - Revised 1.29.2015
Consent Template for Optional Sample Storage and Future Use - Revised 1.29.2015
Survey consent form template - anonymous, no HIPAA - 1-28-2015
Survey consent form template - not anonymous, no HIPAA- 1-28-2015
Consent Template for Humanitarian Use Devices - Revised 7-2-2009. Approval for a humanitarian use device (HUD) involves special considerations from FDA and the HSC. Please contact the HSC Office for more information when proposing the use of an HUD.