Clinical Trial Informed Consent Form

Lays out the purpose and procedures of a clinical study and collects consent signatures from the participant, an optional agent, a witness, and the researchers involved.

Use this template

In the Claude connectors directory

Page 1

Study Title

Purpose of the Study

Study Procedures

Risks and Discomforts

Potential Benefits

Confidentiality

Voluntary Participation and Withdrawal

Page 2

An agent will sign this consent on behalf of the participant

Yes No

A witness will also sign this consent

Yes No

Participant Consent Statement

Name

First Name

Last Name

Signature

Sign here

Date Signed

Agent Consent Statement

Name of Agent

First Name

Last Name

Signature of Agent

Sign here

Date Signed

Witness Statement

Name of Witness

First Name

Last Name

Signature of Witness

Sign here

Date Signed

Researcher Certification

Name of Researcher

First Name

Last Name

Signature of Researcher

Sign here

Date Signed

2nd Researcher

Include a second researcher's signature

Name of Researcher

First Name

Last Name

Signature of Researcher

Sign here

Date Signed

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