Consent Form

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There are five available consent form templates each with a different signature block. Use these templates when creating new consent and assent documents. Choose the signature block(s) that is appropriate for your protocol. When multiple signature blocks apply, create a separate consent document for each one. If you are unsure which signature block(s) to use or have questions, contact Julie Kaberry at 617-432-2149. For assistance drafting and editing consent materials, contact QIP at 617-432-2140.

Consent Form Template

Adult Consent Form

Adult Surrogate Consent Form

Child Assent Form

Parental or Guardian Permission Consent Form

HIPAA Covered Entities