Forms and Templates

Emergency or Compassionate Use Consent Template

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Use this template consent form when requesting consent for treatment with an experimental item.

Change Notes

Align with Nov. 2022 FDA draft consent template and current HSD consent language – 12.05.2023
Add FHCC as site – 08.25.2022
Remove collect call phone number – 04.28.2022
Addition of electronic signatures – 10.16.2020