SUNY DOWNSTATE MEDICAL CENTER NYC + HH Kings County BROOKLYN, NY 11203 INFORMED CONSENT FORM TITLE OF RESEARCH STUDY: Location/Department: Principal Investigator: CAUTION: If the research is sponsored, please trial to see if the sponsor has a model informed consent template. If a model informed consent template is available, please use it instead of this template. Items in italics are general instructions and should be deleted and substituted as indicated. To the extent possible, technical, medical, and scientific concepts should be explained in lay terms that are understandable to someone who is educated to the 6th to 8th grade level. Avoid long sentences and medical/technical jargon, and define any technical terms clearly whenever they are used. If the definitions of technical terms are lengthy, describe in The PI is encouraged to use readability resources, such as: separate sentences. Add pictures, diagrams, tables, or charts if they will improve understanding. If applicable, change the title in header (e.g., PARENTAL PERMISSION, CONTROL GROUP INFORMED CONSENT, etc.). Introduction and Purpose We are asking for your permission to be in a research study. Indicate which site(s) are sponsoring the study. Remove KCHC logo from header and name below, if the research does not take place at KCHC. The is sponsored by the SUNY Downstate Medical Center and NYC Health + Hospitals Kings County.
SUNY DOWNSTATE MEDICAL CENTER NYC + HH Kings County BROOKLYN, NY 11203 INFORMED CONSENT FORM TITLE OF RESEARCH STUDY: Location/Department: Principal Investigator: CAUTION: If the research is sponsored, please to see if the sponsor has a model informed consent template. If a model informed consent template is available, please use it instead of this template. Items in italics are general instructions and should be deleted and substituted as indicated. To the extent possible, technical, medical, and scientific concepts should be explained in lay terms that are understandable to someone who is educated to the 6th to 8th grade level. Avoid long sentences and medical/technical jargon, and define any technical terms clearly whenever they are used. If the definitions of technical terms are lengthy, describe in separate sentences. The PI is encouraged to use readability resources, such as: Add pictures, diagrams, tables, or charts if they will improve understanding. If applicable, change the title in header (e.g., PARENTAL PERMISSION, CONTROL GROUP INFORMED CONSENT, etc.). Introduction and Purpose We are asking for your permission to be in a research study. Indicate which site(s) are sponsoring the study. Remove KCHC logo from header and name below, if the research does not take place at KCHC. The is sponsored by the SUNY Downstate Medical Center and NYC Health + Hospitals Kings County. trial
TEMPLATEConsent-Guidance01.06.2017.docx