Fillable Informed Consent for Participation of a MINOR in (Samford University)

Fill Online, Printable, Fillable, Blank Informed Consent for Participation of a MINOR in (Samford University) Form

Use Fill to complete blank online SAMFORD UNIVERSITY pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Informed Consent for Participation of a MINOR in (Samford University)

On average this form takes 7 minutes to complete

The Informed Consent for Participation of a MINOR in (Samford University) form is 4 pages long and contains:

  • 0 signatures
  • 0 check-boxes
  • 28 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Samford University

BROWSE SAMFORD UNIVERSITY FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Page%1%of%4%
Participant’s initials: __________
IRB approval number:
This form
is valid for one year from approval date. Approval date:
Informed Consent for Participation of a MINOR in a Research Study
Principal%Investigator(s):%
%Study%Title:%
Name%of%participant:%___________________________________________________________________________%%%Age:%________%
1. The%following%information%is%provided%to%inform%you%about%the%research%project/study%and%your%child’s%participation%in%it.%%Please
read%this%form%carefu lly, %ask%any%questions%you%or%your%child%may%have%about%this%study%and%the%information%given%below,%and%be
sure%you%receive%answers%to%your%questions%before%signing%this%consent%form%(a%copy%of%which%will%be%given%to%you).
2.
Purpose of this study:
The purpose of the study is
Your%child%are%being%asked%to%participate%in%a%research%study%because%
3.
The approximate duration of your child’s participation in the study:
4.
Procedures to be followed for this study:
Page%2%of%4%
Participant’s initials: __________
5.
Experimental procedure(s) involved in the study (if any):
6.
Description of the discomforts, inconveniences, and/or risks that can be reasonably expected as a result of your child’s
participation in this study:
7.
Good effects or benefits that might result from this study:
a. The%benefits%to%science%and%humankind%that%might%result%from%this%study:
b. The%benefits%your%child%might%get%from%being%in%this%study%(including%compensation,%if%any):
8.
Alternative procedures or courses of treatments, if any, that might be available:
9.
Privacy and Confidentiality:%%%%All%efforts,%within%reason,%will%be%made%to%keep%your%child’s%personal%information%in%your%child’s
research%record%con fid en tial.%%Yo ur%ch ild’s%info rm a tion %m ay %be%sh are d%w ith %the%S am fo rd %Un iversity%In stitutio n al%Re view %Bo a rd%or
the%Office%for%Human%Research%Protections%(Federal%Government).%%Your%child’s%information%will%only%be%used%for%monitoring
purposes.%
IRB approval number:
This form is valid for one year from approval date. Approval date:
Page%3%of%4%
Participant’s initials: __________
10.
In case of study-related injury:((%If%this%study%involves%more%than%minimal%risk%to%your%child,%the%following%compensation%and/or
medical%treatments%are%available%if%injury%occurs:
11.
Contact information: %%If%you%or%your%child%have%any%questions%about%this%research%study,%your%rights,%or%if%your%child%experiences
a% study related%injury,%please%contact:
at%(
or if principal researcher is a student,%Faculty%Advisor%for%this%study:
at% %%%
If%you%have%additional%questions%or%concerns%that%are%not%answered%by%the%above%person(s),%feel%free%to%contact the%Samford%
University%Institutional%Review%Board%Chair:
Dr. Brad Bennett
205-726-4523
bbennet1@samford.edu%
12.
Your%child’s%participation%in%this%research%study%is%=%6"4*1#..%%You%are%)#''(*%(9 ,*+-# 19 %yo ur%child%from%th is%stu dy %at%an y%tim e
without%penalty.%%Your%child%is%also%)#''(*%(9,*+-#19%from%this%study%with%no%penalty.%%In%the%event%new%info rm atio n%b ecomes
available%that%may%affect%the%risks%or%benefits%associated%with%this%research%study%or%your%willingness%for%your%child%to%participate
in%it,%you%will %b e%n o tif ied %s o %th a t%yo u %and %your%child%can%make%an%inform e d %d ec isio n %whether%o r%n o t%to %c o n tin u e %p a rticipation%in
this%study.
Circumstances under which the Principal Investigator may withdraw you from study participation:
IRB approval number:
This form is valid for one year from approval date. Approval date:
Page%4%of%4%
Participant’s initials: __________
J0D0:K:L0(MN(!:OJPL(EPL J:L0FLB(0P (DQQPR (0S:(KFLPO 7J(!DO0FEF!D0FPL(FL(0SFJ(J0T>N/%
I%have%read %t h is%in fo r m e d %c o n se n t%d o c u ment%and %th e %material%co n ta in e d %in %it%h a s%b e e n %e xp la in e d %to %me%verba lly. %%A ll%m y %
questions%have%been%answered,%and%I%freely%and%voluntarily%choose%to%consent%to%my%child’s%participation%in%this%study.%%I%
have%received%a%copy%of%this%consent%form.%
___________________________________________________________________________________________%
%%Printed%name%of%Parent/Guardian%
__________________________________________________________% __________________________%
%%Signature%of%Parent/Guardian% Date%
KFLPO7J(DJJ:L0(0P(!DO0FEF!D0:(FL(0SFJ(J0T>N%
(For,ages,7A19:,Minor,should,read,or,have,the,following,read,to,him/her,before,signing.),
You%are%invited%to%participate%in%this%study%on:%;*,*6'(%)(&*"-.<.%%
If%you%decide%to%participate,%you%will:%;8#,')6.(-'&5#,8'(9+1*(5+,6-(9,66(-%<.%%
Your%participation%in%this%study%is%voluntary,%and%you%may%stop%at%any%time%without%any%penalty.%%If%we%use%these%results%in%
any%articles%or%presentati
ons,%we%will%not%use%your%real%name%so%your%identity%will%be%protected.%%Please%read%this%
information%and%decide%whether%or%not%you%want%to%participate%in%our%study.%%Thank%you%so%much%for%your%help!%
___________________________________________________________________________________________%
%%Printed%name%of%Participant%
__________________________________________________________% __________________________%
%%Signature%of%Participant% Date%
E%4&'4*(%8*1,4'-(8./%
__________________________________________________________% __________________________________%
%%Printed%name% Title%
__________________________________________________________% __________________________%
%%Signature% Date%
IRB approval number:
This form is valid for one year from approval date. Approval date:
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Informed Consent for Participation of a MINOR in (Samford University)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 26 August 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document