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English Informed Consent Form

The document is an informed consent form for participation in a research study, outlining the participant's voluntary consent, understanding of the study's aims, benefits, and risks. It assures confidentiality and clarifies that there is no monetary compensation for participation, while also stating the participant's right to withdraw at any time without penalty. The form includes spaces for participant and witness signatures, as well as details of the principal investigator.

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Simran Sharma
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40 views1 page

English Informed Consent Form

The document is an informed consent form for participation in a research study, outlining the participant's voluntary consent, understanding of the study's aims, benefits, and risks. It assures confidentiality and clarifies that there is no monetary compensation for participation, while also stating the participant's right to withdraw at any time without penalty. The form includes spaces for participant and witness signatures, as well as details of the principal investigator.

Uploaded by

Simran Sharma
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Informed Consent Form

I, ____________________________________ son of / daughter of ____________________

resident of _______________________________, confirm my voluntary consent to the


participation in the research titled “_____________________________________”

The primary investigator/deputy of the research has explained to me, in a language


comprehensible to me, to my full satisfaction, the aim and nature of the proposed study, as
well as its benefits and risks. I have been assured that my confidentiality shall not be violated
in any way during the course of the research and in any subsequent publications of this
research.

I am aware that I will not be given any monetary compensation for my participation in this
research. I have been given the opportunity to raise any concerns or queries regarding my
participation in this research, and all my concerns have been resolved.
I confirm that my participation is voluntary and of my own free will. I am aware of right to
opt out of this research at any point without giving any reason(s), and that I have the right to
withdraw without penalty or loss of my routine healthcare benefits.
I confirm that I have read this informed consent form (or had it read to me), and understood
the information so provided in the same.

Participant name and signature / thumb print

Witness name and signature / thumb print

Principal Investigator/Deputy name and signature


Date and Time:

Principal Investigator: Dr. ____________


Designation & Affiliation: Assistant Professor, Pharmacology, AIMSR, Bathinda
Contact number: 0164 5055024

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