Sample Templates
Sample Informed Consent/Assent Templates
**Templates updated 5-21-2018 to include common rule changes
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Adult Informed Consent Template
[PDF] [
DOC]
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Exempt Informed Consent Template
[PDF] [
DOC]
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Interview Consent Template [
PDF] [
DOC]
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Online Survey Consent Template [
PDF] [
DOC]
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Parental Permission Letter [
PDF] [
DOC]
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Child Assent Script Sample (Age 7-13)
[PDF] [
DOC]
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Child Assent Script Sample (Age 14-17) [
PDF] [
DOC]
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Consent Form for Flint Psych Pool (Under 18) [
PDF] [
DOC]
Self Determination Templates: If you plan to use the eResearch path for self determination of your exempt study, please use these templates for consent
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Self-determination Exempt Informed Consent Template
[PDF] [
DOC]
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Self-determination Focus Group Consent Template
[PDF] [DOC]
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Self-determination Interview Consent Template [
PDF] [
DOC]
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Self-determination Online Survey Consent Template [
PDF] [
DOC]
Sample Recruitment
- Recruitment Template and Guidelines [PDF] [DOC]
- Template for use of UM-Flint Email for online survey [PDF] [DOC]
Sample Debriefing
- Debriefing Template [PDF] [DOC]