ࡱ> 685_ bjbjڿڿ *$-b-b"8Pd$T4ccc$>"lccccccRcnW`%_ $0T ""@" ccccccTcccc"cccccccccB : Consent Form Guidelines Review Board for Research with Human Subjects For studies requiring written consent Identification The consent form must identify, preferably in the heading: The organization which sponsors the research of the individual performing the study, i.e. Ҵý. Identifying information of the faculty member or supervisor and the principal investigator: name department contact information: phone number, e-mail address The location in which the research will take place Procedural Information Information provided about the study must include: All procedures, most preferably in chronological order A description of the procedures which are considered experimental and why they are experimental A clear explanation of all medical and technical terminology The amount of time required per session and for the entire duration of the study example: This study will include the use of a questionnaire that you will be required to fill out. Voluntary Participation In an agreement for voluntary participation, it must be included in the consent agreement that: Participation in the study is completely voluntary Refusal to participate will result in no penalty to the subject Withdrawal from the study will also not result in penalty to the subject example: If at any time you feel uncomfortable, or that you can not complete any of these measures, or wish to stop the experiment, you may do so at any time without any penalty or loss of any credit Confidentiality The agreement upon confidentiality in the consent agreement must include: The method of maintenance of the records of the study by the researcher The amount of information required by the researcher about the subject example: This information will be kept confidential. You will only be known by your experimental numbers. Risk The explanation of risk that is required to be given in a consent agreement for a potential subject must include: Any and all foreseeable risks and discomforts The probability and possible magnitude of harm the subject may encounter while participating in the study All the measures that will be taken by the researcher in order to minimize risk to the subject example: In filling out this questionnaire if you at any time feel uncomfortable or if it is causing you undue stress, you may withdraw immediately from the study Compensation Upon agreement on compensation (i.e. experimental credit)for a potential subject, the consent agreement must include: A direct statement upon the exact nature of the compensation that will be received by the subject, should they choose to participate in the study The compensation given to a subject, should they withdraw from the study prior to its completion example: By participating in this study, you will earn one experimental credit. In the event that you should withdraw from this study before its end, then you will still receive the credit. Signature In the subject's agreement to consent to participate in the study, the following must be included: That the subject acknowledges reading the consent form That any questions the subject had about the research and the consent form had been answered The subject agrees to the terms by which the consent form states and therein agrees to participate in the study example: I _(print name)_ do verify that I have read this consent form and do so agree to participate in this study ____(signed)___ The following must be included in the consent process in order for the study to be deemed valid: Anyone from whom data would be extracted would have to have given consent before such data could be used Any administrator who approves the use of data must also sign a consent form The consent form must be signed by an adult, in the case of minors a parent or legal guardian     Rev. 9/05 Flmn~  F j l I J  +&,:Hpq{]hik56꿷귿꿷꿷꿷꬟꿛꿛hc>*CJOJQJhchc6>*CJOJQJhc6CJOJQJhcOJQJhcCJOJQJhc>*CJOJQJhc56CJhc56CJOJQJhcCJOJQJhc>*CJOJQJ7Fmn}~   F }  k l I  & F & F h^ & F $a$I J }   +s&+,69:GHP & F & F & F & FPpq{|sXijk6 & F  & F  & F hcCJhcjhcU  & F $a$(/ =!"#$% s666666666vvvvvvvvv666666>6666666666666666666666666666666666666666666666666hH66666666666666666666666666666666666666666666666666666666666666666p62&6FVfv2(&6FVfv&6FVfv&6FVfv&6FVfv&6FVfv&6FVfv8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@_HmH nH sH tH 8`8 Normal_HmH sH tH DA D Default Paragraph FontZiZ  Table Normal :V 4 l4a _H(k (No List 4@4 Header  !4 @4 Footer  !PK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭Vc:E3v@P~Ds |w< :$ !$ I P 8@0(  B S  ?ls$X` \ ^ 333333333333 s BR$ $v%' J4 ;:2> C=B> ZiR goR P_ Vh s(wRVx g\  hh^h`OJQJo( hh^h`OJQJo( hh^h`OJQJo( hh^h`OJQJo( hh^h`OJQJo( hh^h`OJQJo( hh^h`OJQJo( hh^h`OJQJo(hh^h`. hh^h`OJQJo( hh^h`OJQJo( hh^h`OJQJo( hh^h`OJQJo( goRBR$RVx;:2>J4P_Vh$v%'sZiRg\sC=B> oc@@UnknownG* Times New Roman5Symbol3.* Arial;WingdingsA$BCambria Math"hggkiF8 8 !4KP X]2!xx  Consent FormsLeslie A. ShermanWAC@         Oh+'0   @ L X dpxConsent FormsLeslie A. ShermanNormalWAC2Microsoft Office Word@F#@'#P^@0 %@0 %8  ՜.+,0 hp  Ҵý Consent Forms Title  !"#$&'()*+,./012347Root Entry F`%91Table"WordDocument*$SummaryInformation(%DocumentSummaryInformation8-CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q