UW Research

Forms and Templates

TEMPLATE Consent Form, Standard


The purpose of this template is to provide general sample language for consent forms.

NOTE: The GUIDANCE Consent, and TIPSHEET Consent provide the most up-to-date description of best practices for designing consent forms. HSD is currently working on updating our consent templates to match the GUIDANCE. In the meantime, HSD encourages using the GUIDANCE to create consent forms, but forms submitted using this template are acceptable.

Change Notes

Revise data sharing language to reflect NIH DMS policy – 11.30.2022
Revise CoC language – 10.27.2022
Remove outdated template language for FDA-regulated device clinical trials; update template language regarding records retention requirements for subject identifiers – 08.04.2022
Revise researcher signature requirements; update links to consent suite materials – 10.08.2021
Revisions to guidance about subject payment language; clarify information about expiration dates for NIH CoCs – 08.26.2021
Add instructions regarding provision of e-copy of consent form – 03.25.2021
Addition of electronic signatures – 10.15.2020
Minor revision related to HSAP and Industry studies – 05.29.2020
Revise Certificate of Confidentiality statements to be inclusive of multi-site and collaborative research designs and instruction to remove this statement when the CoC expires; add instruction about UWMC policy for uploading translated consent forms to UWMC medical records – 11.15.2019
Added NIH language for fetal tissue – 09.09.2019
Fixed broken link to UW Finance web page – 07.28.2019
Added helpful language regarding the purpose of the Key Information statement – 01.18.2019
Small addition to the section regarding research that uses UW clinical services – 11.30.2018
Updated to include the new Key Information statement for the revised Common Rule, and new elements of consent – 10.03.2018
Added language for international Certificate of Confidentiality; updated language regarding asking for Social Security Numbers; added place in footer for researchers to update their own date and version number – 08.24.2018
Financial interest section significantly simplified – 01.12.2018
Removed instructional reference to the Request Waiver form – 06.23.2017