Model Forms

These documents are samples from prior study submissions.  These samples are study specific and should be used as examples only. Do not submit a model form as a study consent form. Use the most current consent template and adjust accordantly to your study.  NOTE: These documents are not updated regularly.

Consent Templates & Guidance
Sample Protocol New
Sample Data Monitoring Forms
Sample Screening Tools
Sample Evaluation Documents

Consent Guidance & Templates
(includes a sample understanding tool, waiver of consent, risk statements, & telephone script)

• Suggested Language: Please note, separate consent forms are needed for minors and adults. When developing a minor consent form, replace the adult signature lines with those designated for minors in the suggested language.
• Assessment of Understanding Tool
• Case Study Consent
• Database Consent
• HUD Consent
• Risk Statements
• Telephone Script
• Waiver of Consent Guidance

Sample Data Monitoring Forms

• Data Monitoring Committee
• Data Monitoring Plan
• Data Monitoring Progress Report

Sample Screening Tools

• Screening Tool 1
• Screening Tool 2

Sample Evaluation Documents

• Participant Satisfaction Letter
• Study Evaluation

Last updated: 10/23/08