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2801 N. Sheffield, 2nd Floor Chicago, IL 60657 7732818130 www.studioforchange.com INFORMED CONSENT CHECKLIST FOR TELEHEALTH SERVICES Prior to starting videoconferencing services, we discussed and
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How to fill out informed consent checklist for

01
Start by filling in the header section of the informed consent checklist. This includes the participant's name, study title, and date of consent.
02
In the introduction section, briefly explain the purpose of the study and what participation entails. Ensure that the language used is clear and easily understandable.
03
Provide a detailed description of the study procedures, including any risks or potential benefits involved. This section should also outline any alternative options available to the participant.
04
Clearly state the participant's rights and responsibilities throughout the study. This may include the right to withdraw from the study at any time.
05
Obtain the participant's signature and date in the designated section to indicate their informed consent to participate in the study.
06
If applicable, include a section for obtaining consent from a parent or guardian for participants who are under the age of 18 or legally incapable of giving consent.
07
Ensure that all necessary contact information is provided, including the researcher's name, email address, and phone number. This allows participants to reach out with any questions or concerns.
08
Make a copy of the completed informed consent checklist for both the participant and the researcher's records.
09
Keep all copies of the informed consent checklist in a secure and confidential manner.
10
Regularly review and update the informed consent checklist as necessary to ensure it remains accurate and up-to-date.

Who needs informed consent checklist for?

01
Informed consent checklists are necessary for any research or study involving human participants. This includes both medical and non-medical research studies conducted in various fields such as psychology, sociology, biology, and medicine. Informed consent checklists are important to ensure that participants are fully aware of the study's purpose, procedures, risks, benefits, and their rights as participants. It is also a legal and ethical requirement to obtain informed consent from participants, especially when conducting research that involves potentially sensitive or invasive procedures.
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The informed consent checklist is used to ensure that all necessary information has been provided to a participant before they agree to take part in a research study.
Researchers and study coordinators are required to file the informed consent checklist for any participants involved in a research study.
The informed consent checklist should be filled out by including all the required information such as study details, risks and benefits, contact information, and signature lines for the participant and researcher.
The purpose of the informed consent checklist is to ensure that participants have been fully informed about the research study and have provided their voluntary consent to participate.
The informed consent checklist must include details about the research study, potential risks and benefits, contact information for the researcher, and signatures from both the participant and researcher.
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