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Sample Informed Consent Form: Instructions To The Student Researcher

This document provides a sample informed consent form for student researchers to use when conducting science fair projects involving human subjects. The form outlines key elements that should be included such as the purpose of the project, time required for participation, potential risks and benefits, how confidentiality will be maintained, and that participation is voluntary. It also provides signature blocks for participants or their parents to provide their informed consent or permission.

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santhoshputhoor
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454 views

Sample Informed Consent Form: Instructions To The Student Researcher

This document provides a sample informed consent form for student researchers to use when conducting science fair projects involving human subjects. The form outlines key elements that should be included such as the purpose of the project, time required for participation, potential risks and benefits, how confidentiality will be maintained, and that participation is voluntary. It also provides signature blocks for participants or their parents to provide their informed consent or permission.

Uploaded by

santhoshputhoor
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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SAMPLE INFORMED CONSENT FORM

INSTRUCTIONS TO THE STUDENT RESEARCHER:


An informed consent/assent/permission form should be developed in consultation with the Adult Sponsor, Designated
Supervisor or Qualified Scientist.
This form is used to provide information to the research participant (or parent/guardian) and to document written informed
consent, minor assent, and/or parental permission.
When written documentation is required, the researcher keeps the original, signed form.
Students may use this sample form or may copy ALL elements of it into a new document.
If the form is serving to document parental permission, a copy of any survey or questionnaire
must be attached.

STUDENT RESEARCHER:

TITLE OF PROJECT:

I am asking for your voluntary participation in my science fair project. Please read the following information about the project.
If you would like to participate, please sign in the appropriate box below.

PURPOSE OF THE PROJECT:

IF YOU PARTICIPATE, YOU WILL BE ASKED TO:

TIME REQUIRED FOR PARTICIPATION:

RISKS:

BENEFITS:

HOW CONFIDENTIALITY WILL BE MAINTAINED:

If you have any questions about this study, feel free to contact:

Adult Sponsor: ___________________________________ Phone/email: ______________________________

VOLUNTARY PARTICIPATION:
Participation in this study is completely voluntary. If you decide not to participate there will not be any
negative consequences. Please be aware that if you decide to participate, you may stop participating at
any time and you may decide not to answer any specific question.

By signing this form I am attesting that I have read and understand the information above and I freely give
my consent/assent to participate or permission for my child to participate.

ADULT INFORMED CONSENT OR MINOR ASSENT Date Reviewed & Signed: ____________________________

Printed Name of Research Subject: _________________ Signature:_____________________________________________

Parental/Guardian Permission (if applicable) Date Reviewed & Signed: _____________________________

Parent/Guardian Printed Name: _________________ Signature:_________________________________________

16 Regeneron Science Talent Search 2018

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