Case Study Consent Form

A brief form where a participant gives written authorization for their case to be documented and used as a case study.

Use this template

Reference Number

Case Study Name

Participant Name

Nombre

Apellido

I, as a participant of the case study specified above, agree with the following statements I selected

I authorize the use of my information for the case study I authorize the publication of the study's results

Date

Signature

Sign here

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