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RESEARCH ASSENT FORM Use Plate or Print: MAN#:DO NOT PLACE IN MEDICAL RECORD DOB: Protocol Title: Society for Pediatric Anesthesia Improvement Network (SPAIN) Chest Wall Deformity Project Pt Name:

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How to fill out research consent form

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Start by reading the research consent form carefully to understand all the provided information.

02

Write your full name, contact information, and any other required personal details.

03

Make sure to date the form accurately.

04

Read and comprehend the purpose, procedures, and potential risks involved in the research.

05

If you have any questions or concerns, reach out to the research team for clarification.

06

Give your consent by signing and dating the form.

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Keep a copy of the completed research consent form for your records.

Who needs research consent form?

01

Anyone participating in a research study or project that requires informed consent needs to fill out a research consent form. This includes individuals who are willing to participate in medical trials, surveys, interviews, experiments, or any other research activity where informed consent is necessary.

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