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UNIVERSITY OF PENNSYLVANIA RESEARCH SUBJECT INFORMED CONSENT & HIPAA AUTHORIZATION FORMProtocol Title:Part Study to Evaluate the Safety and Efficacy of Image Guided Surgery using NearInfrared dyes

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How to fill out informed consent form template

01

Read the informed consent form carefully to understand the purpose of the study or treatment.

02

Fill in your personal information such as name, address, date of birth, and contact information.

03

Sign and date the form to indicate your willingness to participate or consent to the treatment.

04

Make sure to ask any questions or seek clarification on any points before signing the form.

Who needs informed consent form template?

01

Informed consent form template is needed by research subjects, patients undergoing medical treatments, participants in clinical trials, and anyone taking part in a study or program that requires their consent.

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What is informed consent form template?

An informed consent form template is a document that outlines the risks, benefits, and potential alternatives to a medical procedure or research study.

Who is required to file informed consent form template?

Healthcare providers, researchers, or institutions conducting medical procedures or research studies are required to file an informed consent form template.

How to fill out informed consent form template?

To fill out an informed consent form template, one must provide detailed information about the procedure or study, risks, benefits, alternatives, and obtain the signature of the patient or participant.

What is the purpose of informed consent form template?

The purpose of an informed consent form template is to ensure that individuals have a full understanding of the risks and benefits associated with a medical procedure or research study before agreeing to participate.

What information must be reported on informed consent form template?

The informed consent form template must include information about the procedure or study, risks, benefits, alternatives, confidentiality, and the right to withdraw.

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