your mind and withdraw your permission to store them at any time. WHAT ARE THE POSSIBLE BENEFITS? This study will not help you directly; however, you will receive clinical laboratory test results that may give you and your doctor more information about your health (for example, complete blood count). The main reason you may want to take part is to help researchers make discoveries that might help you and other people now and in the future. ARE THERE ANY COSTS OR PAYMENTS? There are no costs to you. You [cru to modify: will/will not] be paid [cru to include compensation that will be provided, if applicable]. If any of the research leads to new tests, drugs, or other commercial products, you will not share in any profits. If you experience injury as part of this research study, [CRUs to add what care is to be provided, per irb/iec requirements]. WHAT ARE MY OPTIONS? Taking part in this study is your choice. You can choose to take part or not to take part. If you choose to take part, you can change your mind at any time. WILL I BE TOLD IF THERE ARE NEW FINDINGS? You will be given clinical laboratory test results that are done for this study. These results may give you and your doctor information about your health, specifically about TB, anemia, diabetes, and HIV. You will not get test results from the samples that are collected for the biobank. These samples will be used by researchers in the future; and therefore, we will not have any test results to share with you. If you are interested in learning whether or not there are new findings [enter name of contact person] at [telephone number]. in the future, you may contact WHAT IF I CHANGE MY MIND? You can decide to withdraw your permission whenever you want. If you decide to withdraw your permission, contact the research There are two ways to withdraw your permission. You could allow researchers to remove all your personal identifiers linked to your stored samples, so that they are not linked to you anymore. These samples will then become anonymous. Or, you can ask researchers to destroy the samples. However, in either case, researchers will not be able to destroy samples or information from research that is already underway. If some tests have already been completed on your samples, any remaining samples will be destroyed. If you withdraw your permission, there will be no
your mind and withdraw your permission to store them at any time. WHAT ARE THE POSSIBLE BENEFITS? This study will not help you directly; however, you will receive clinical laboratory test results that may give you and your doctor more information about your health (for example, complete blood count). The main reason you may want to take part is to help researchers make discoveries that might help you and other people now and in the future. ARE THERE ANY COSTS OR PAYMENTS? There are no costs to you. You [cru to modify: will/will not] be paid [cru to include compensation that will be provided, if applicable]. If any of the research leads to new tests, drugs, or other commercial products, you will not share in any profits. If you experience injury as part of this research study, [CRUs to add what care is to be provided, per irb/iec requirements]. WHAT ARE MY OPTIONS? Taking part in this study is your choice. You can choose to take part or not to take part. If you choose to take part, you can change your mind at any time. WILL I BE TOLD IF THERE ARE NEW FINDINGS? You will be given clinical laboratory test results that are done for this study. These results may give you and your doctor information about your health, specifically about TB, anemia, diabetes, and HIV. You will not get test results from the samples that are collected for the biobank. These samples will be used by researchers in the future; and therefore, we will not have any test results to share with you. If you are interested in learning whether or not there are new findings in the future, you may contact [enter name of contact person] at [telephone number]. WHAT IF I CHANGE MY MIND? You can decide to withdraw your permission whenever you want. If you decide to withdraw your permission, contact the research There are two ways to withdraw your permission. You could allow researchers to remove all your personal identifiers linked to your stored samples, so that they are not linked to you anymore. These samples will then become anonymous. Or, you can ask researchers to destroy the samples. However, in either case, researchers will not be able to destroy samples or information from research that is already underway. If some tests have already been completed on your samples, any remaining samples will be destroyed. If you withdraw your permission, there will be no
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