Medical Informed Consent

Explain a procedure or study, its risks and alternatives to participants before they agree. It collects signatures from the participant, a guardian for minors, a witness when the participant cannot read, and the researcher.

Use this template

In the Claude connectors directory

Study Title and Purpose

Procedures

Risks and Discomforts

Benefits

Alternative Treatments

Confidentiality

Voluntary Participation

Contact Information

Participant Statement

Participant Name

First Name

Last Name

Is the participant of legal age?

Yes No

Participant Signature

Sign here

Date Signed

Parent or Guardian Name

First Name

Last Name

Parent or Guardian Signature

Sign here

Date Signed

Relationship to Participant

Participant literacy

The participant cannot read

Literate Witness Name

First Name

Last Name

Witness Signature

Sign here

Witness Signature Date

Researcher Statement

Researcher Name

First Name

Last Name

Researcher Signature

Sign here

Researcher Signature Date

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