Sample Consent Forms


The following are some samples of informed consent forms.  They are tools to help you compose your own form that will be tailored to your specific research project.  All consent forms must address the elements of informed consent outlined in the informed consent checklist.

Sample 1:  Cover Letter for Survey (pdf) (doc)

Sample 2:  Cover Letter for Survey (Sensitive Topic) (pdf) (doc)

Sample 3:  Signed Consent Form -- List Format (pdf) (doc)

Sample 4:  Signed Consent Form -- More Than Minimal Risk to Participants (pdf) (doc)

Sample 5:  Signed Consent Form -- Parental Letter Template (pdf) (doc)

Sample 6:  Signed Consent Form -- Assent for Child (pdf) (doc)

Sample 7:  Sample Language to Include for Audio/Videotaping Subjects (pdf) (doc)

Sample 8:  Sample Language to Include for Research that Involves Protected Health Information (pdf) (doc)