statement of informed consent 模板

statement of informed consent 模板

Informed Consent for Participation in [study/project title]

Investigator(s): [investigator name(s)]

Introduction

You are being asked to participate in a study/project titled

[study/project title]. Before you decide whether or not to

participate, it is important that you understand the purpose of the

study, what it involves, and any potential risks or benefits

associated with your participation. Please take the time to read this

document carefully. If you have any questions or concerns, feel

free to ask the investigator(s) before deciding whether or not to

participate.

Purpose

The purpose of this study/project is to [briefly describe the purpose

and objectives].

Procedures

If you agree to participate, you will be asked to [describe the

specific procedures involved, including any data collection

methods or interventions]. The estimated time commitment for

participation is [provide an estimate of the time required].

Risks and Benefits

Although every effort will be made to minimize risks, there are

potential risks associated with participating in this study/project,

such as [list any potential physical, psychological, or social risks].

On the other hand, potential benefits of participating may include

[list any potential benefits, if applicable].

Confidentiality and Data Protection

Your privacy is important, and all data collected during this

study/project will be treated with strict confidentiality. All personal

identifying information will be removed and replaced with a

unique identifier to ensure anonymity. Only the investigator(s) will

have access to the data, and it will be stored securely in accordance

with applicable data protection regulations.

Voluntary Participation and Withdrawal

Participation in this study/project is voluntary, and you have the

right to withdraw at any time without penalty or negative

consequences. Your decision to participate or not will not affect

your current or future relationship with [organization/institution].

If you decide to withdraw, any data already collected may still be

used unless you specify otherwise.

Contact Information

If you have any questions or concerns throughout the course of the

study/project, you can contact the investigator(s) at [provide

contact information].

Statement of Consent

I have read and understood the information provided in this

document, and I have had the opportunity to ask any questions or

seek clarification. I voluntarily agree to participate in this

study/project, and I understand that I can withdraw at any time

without penalty.

Participant Name: ______________________

Participant Signature: ____________________

Date: ____________________