PARTICIPANT INFORMATION SHEET
INFORMATION FOR PARTICIPANTS OF THE STUDY
Title of the study
Principal investigator:
Procedure:
Voluntary participation: Participation in this study is entirely voluntary. There is no compulsion to
participate in this study. You are required to sign if you are willing to participate in this study. You have
full freedom to withdraw from the study at any time during the study
Confidentiality: We assure that all the records will be confidential and will not be disclosed to anyone
except if it is required by the law. This information collected will be used only for research. This
information will not reveal your identity. There is a possibility of current and future uses of the data to be
generated from the research and data is likely to be used for sharing in a journal.
We would not compel you any time during this process, also we would greatly appreciate your
cooperation in this study. We would like to get your consent to participate in this study.
For any information you are free to contact the investigator. This study has been approved by the
Institutional Ethics Committee and has been started only after their formal approval.
Name and Signature of the participant Signature of the investigator
Date: Date:
Place: Place
INFORMED CONSENT FORM
Title of the project:
Participant’s name:
The details of the study have been provided to me in writing and explained to me in my own language. I
confirm that I have understood the above study and had the opportunity to ask questions. I confirm that
I have understood the compensation and the risks and benefits involved in this research. I understand
that my participation in the study is voluntary and that I am free to withdraw at any time without giving
any reason. I understand that confidentiality of my identity will be maintained during the research
period, after its completion as well as during publication of the results. Only investigators, ethics
committees, institutional or regulatory authorities may have access to my information when required.
I have been given a copy of an information sheet giving details of the study. I volunteer to participate in
the above mentioned study.
Name and Signature/thumb impression of the participant: ___________________Date: _____________
Signature of the witness with date: ______________________________________Date: _____________
