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Sample of consent form

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  • 1. 203 Consent FormI have read the consent form and recognize that my participation in this study is entirelyvoluntary and that I am free to withdraw at any time during the course of the study withoutconsequence. I understand that any information resulting from this study will be strictlyconfidential. I realize that I may ask for further information about this study if I wish to do soat any time.I have received a copy of this consent form for my own records. I agree to participate in thisstudy._____________________________ _____________________________Subject Signature Date_____________________________Print Name of the Subject

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