UW Research

Forms and Templates

TEMPLATE Consent Form, Standard


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

Change Notes

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