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Consent Form Templates
Sample Assent Forms
Other Forms
Exempt Consent Templates and Guidance
Consent Form Templates
These templates are appropriate for studies that require expedited or full committee review. There are separate consent templates for exempt research, which includes some research that involves educational tests, surveys, interviews or focus groups.
Please note:
- Review the Consent Guidelines and Standard Wording before writing your consent form.
- Keep the upper right-hand corner blank and use at least a 1.25" top margin.
- See the NCNN Informed Consent Language Database for lay language terms.
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Template by Type of Research |
Last Updated |
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July 2019 (Common Rule Compliant) |
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| April 2019 (Common Rule Compliant) | |
| April 2019 (Common Rule Compliant) | |
| April 2019 (Common Rule Compliant) | |
| April 2019 (Common Rule Compliant) | |
| December 2015 | |
| Telephone Script (Main Study Procedures) -- Use this if you are conducting consent for study procedures over the telephone (verbal consent) | August 2019 |
| Telephone Script (Eligibility Screening only) -- Use this if the verbal consent is only for an over-the-phone eligibility screening. | August 2019 |
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Consent Form Addendum (general) —Use if you need to provide new study info to previously enrolled subjects. |
March 2016 |
| Enrollment Exception Consent Form Addendum -- Use if you are submitting a Protocol Enrollment Exception Request Form and there is a specific risk information for the individual subject. | January 2018 |
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Humanitarian Use Device —You may also use the sponsor’s version of the consent form, as long as you modify it to identify the UCSF investigator's name, department, and local contact number and provide the contact number for the UCSF IRB (415-476-1814). |
May 2016 |
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VA Consent Form 10-1086 Template — See the SFVAMC page for info on this form. |
Sample Assent Forms
| Age of Children | Last Updated |
| Assent #1 - For children 7-12 (simple) | December 2004 |
| Assent #2 - For more complex study, more mature children | December 2004 |
| Assent #3 - For adolescents 13-17 | December 2004 |
| Guidance on Obtaining Assent and Parental Permission |
Other Forms
| UCSF Subject Authorization for Release of PHI for Research and Additional HIPAA-related Forms and Guidance |
|
Experimental Subjects Bill of Rights (English) and Other Languages |
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Federal Requirements for Approving Consent Forms Checklist (Note: UCSF consent form templates incorporate all of the federal requirements.) |
