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RESEARCH ASSENT FORM Use Plate or Print: MAN#:DO NOT PLACE IN MEDICAL RECORD DOB: Protocol Title: Pediatric Anesthesia Care Unit (PACE) Outcome Evaluation Project Pt Name:Principal Investigator: Patchier
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How to fill out research assent form

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Step 1: Read the entire research assent form carefully.
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Step 2: Understand the purpose of the research and what your participation entails.
03
Step 3: Fill in your personal information accurately, such as your name, age, and contact details.
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Step 4: Review any risks or benefits associated with the research.
05
Step 5: Consent to participate by signing and dating the form, if you agree to the terms.
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Step 6: Ask any questions you may have before signing the form.
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Step 7: Keep a copy of the form for your records.

Who needs research assent form?

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Research assent forms are typically needed for participants who are minors or individuals who may have limited capacity to give informed consent, such as those with cognitive disabilities.
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These forms ensure that individuals understand the research objectives and potential risks involved, and provide an opportunity for them or their authorized representatives to give permission for their participation.
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The research assent form is a document that explains the research study in simple language to participants and obtains their agreement to participate.
Researchers conducting studies involving participants who may not be able to provide informed consent, such as children or individuals with cognitive impairments, are required to file a research assent form.
Research assent forms are typically filled out by providing relevant study information, explaining the purpose of the research, and obtaining signature or verbal assent from participants.
The purpose of the research assent form is to ensure that participants understand the study they are participating in, and to obtain their agreement to take part.
Research assent forms should include details about the study purpose, procedures, risks and benefits, confidentiality measures, and contact information for questions or concerns.
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