Informed Consent Template (English Language) - UCLA ：知情同意的模板（英文）-加州大学洛杉矶分校.doc

NCI-UCLA CONSENT FORM TEMPLATE Template Instructions: Instructions and examples for informed consent authors are in [italics]. A blank line, __________, indicates that the local investigator should provide the appropriate information before the document is reviewed with the prospective research participant. The term ‘study doctor’ has been used throughout the template because the Principal Investigator of a cancer treatment trial is a physician. If this template is used for a trial where the Principal Investigator is not a physician, another appropriate term should be used instead of ‘study doctor’. The template date in the header is for reference to this template only and should not be included in the informed consent form given to the prospective research participant. Consent authors should review the UCLA Consent Form Standards on the OHRPP website for more information about UCLA consent forms. These notes for authors and investigators are instructional and should not be included in the informed consent form given to the prospective research participant. UNIVERSITY OF CALIFORNIA LOS ANGELES CONSENT FORM FOR ONCOLOGY RESEARCH [Insert title of the study] [Insert a lay or working title of the study – for study participants] INTRODUCTION [Insert name and degrees of the Principal Investigator], and associates from the [insert department affiliation] at the University of California, Los Angeles are conducting a research study. This is a clinical trial, a type of research study. Your study doctor will explain the clinical trial to you. Clinical trials include only people who choose to take part. Please take your time to make your decision about taking part. You may discuss your decision with your friends and family. You can also discuss it with your health care team. If you have any questions, you can ask your study doctor for more explanation. You are being asked to take part in this study because you have… [Type/stage/presentation of cancer being stu