Informed Consent for Participation in Oral Surgery Research

Study Information

Title of Research Study: [Insert Study Title] Principal Investigator: [Name], [Credentials] Institution: [Institution Name] Study ID: [Protocol Number]

Purpose and Procedures

I understand that I am being asked to participate in a research study involving:

• [Brief description of the study purpose]
• [Expected duration of participation]
• [Description of procedures]

Risks and Benefits

Potential Risks

• [List specific risks]
• [Include both common and rare complications]
• [Note any risks specific to research procedures]

Potential Benefits

• [List direct benefits to participant, if any]
• [Describe broader benefits to scientific knowledge]

Participant Rights and Confidentiality

1. Participation is voluntary
2. Right to withdraw at any time without penalty
3. Protection of personal health information
4. Data storage and security measures

Financial Considerations

• Compensation details: [Insert details]
• Costs to participant: [Insert details]
• Insurance coverage information

Authorization

By signing below, I acknowledge that:

• I have read and understand this consent form
• All my questions have been answered
• I voluntarily agree to participate

Participant Name (Print)

Participant Signature

Date

Investigator Signature

Contact Information

Principal Investigator: [Phone] Research Coordinator: [Phone] IRB Office: [Phone]