IRB FORM D – Human Subject Consent Form Checklist
Please answer ALL of the questions below and submit along with your Application Form A, B, or C and Form E.
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Principle Investigator's Name *
1. Is the consent form written in clear, understandable language? *
2. Is it free of any language that requires the subjects to waive their legal rights, including any release of the investigator, sponsor or college or its agents from liability for negligence? *
3. If minors are included in the study, is provision made for obtaining parental/guardian consent? (Please note: A minor is under 18 years old, and we have many early admit students. If you answer NO or NOT APPLICABLE to this question, you are required to address how you will ensure these students will not participate in the study on your FORM A, B, or C.) *
4. Does the consent form include each of the following basic elements of informed consent?
a. A statement that the study involved research, an explanation of the purposes of the research and the expected duration of the subject’s participation. *
b. A description of the procedures to be followed. *
c. A description of any benefits to the subject or others *
d. A description of any reasonably foreseeable risks or discomforts. *
e. A statement describing the extent to which confidentiality of records identifying the participant will be maintained. *
f. Information regarding whom to contact for answers to questions about the research study and the research. *
g. A statement that participation is voluntary, refusal to participate will involve no penalty or loss of benefits, and the participant may discontinue participation at any time without penalty or loss of benefits. *
h. Appropriate FERPA notice and waivers (if appropriate). *
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