Consent Form

There are five available consent form templates each with a different signature block. Use these templates when creating new consent and assent documents. Choose the signature block(s) that is appropriate for your protocol. When multiple signature blocks apply, create a separate consent document for each one. If you are unsure which signature block(s) to use or have questions, contact Julie Kaberry at 617-432-2149. For assistance drafting and editing consent materials, contact QIP at 617-432-2140.

Consent Form Template

Adult Consent Form  Revised

Adult Surrogate Consent Form  Revised

Child Assent Form Revised

Parental or Guardian Permission Consent Form  Revised

HIPAA Covered Entities  Revised

Short Form Consent Revised