ÿWPCå †Œ5Ñ`æ ‹c3p† c§a²ºJy›Òœð à¿»hñíБ9O1ÏWÐýiÿ’]ñtá5ìC÷æm‰¶:°þŸo•ïd,›D\w^^XT--u…bL*Ÿxϧ§Ø¦M蘒êúÔ®9wÂì¦3ýÛäöËÓc—uì÷¹cggôËxTTkzA)Más³ôIcÓÌ(±—§Óy«YˆÍ€,&$¢hîýÉTyê/˜hçÑLJÒV`.Â/A[Õb˜~k£4¯˜%€¥]‰Ëá‡e‹è¥‘ã'*°Œƒ–þ/îRz›¯][⋞KµŠý¢ãŠ\™ï\mV? É)22m»‚ t£³bÿRU~ºBBM’Îf!ΰÿñ‡ŒÌÜUd‹}…mÌ %ÝùÖ‰“0yK>/’}Bæ};hI~lù,.t$f»ìµUD/“²áëìqá1¥õºj¤1' ÞÇÀ§cBM4]“šŽŸ:ºb‘Ã5Z%¡#Ëë¼]?ãÊójÕh^ŽË‘ìâ cM =ÑüC”þUü÷ Ù|ƒÝg@ü™'>žØ+LC:ÒBÅ"ø¨l.¬!äÄÑ‚™w®+'£5u8`O$¢Ã]ųmAÀÕ[= “#ÁÄUN… %Ó 0(Ùw4( m*ŽAÏN×^ Ù˜HP LaserJet Series II,È,,,,,È0(ÖÃ9 Z‹6Times New Roman RegularX($¡¡å|³(er8ê€3|xÿU‹ÿÀÀÀexample adult research consent Ð ( ' BSN0876460BSN087646 .    V±:) Ý ƒ!ÝÝ  ÝÔ_ÔÓ  Óò òSAMPLE€Adult€Consent€formó óÐ ° ÐÌÓ  Óà  àYou€are€being€invited€to€participate€in€a€research€project€byòò€ûÿÿdûDr.€Researcheróó€òòAlphaüÿÿdüóó€€andÐ ˆØ ÐòòûÿÿdûStudent€Researcher€Betaüÿÿdüóó€from€the€University€of€Louisiana€at€Lafayette.€This€study€will€beÐ tÄ Ðconducted€to€determine€whether€Adults€in€Louisiana€will€participate€in€research.€€You€wereÐ `° Ðselected€to€participate€in€this€study€by€taking€names€at€random€from€the€1990€census€of€the€StateÐ L œ Ðof€Louisiana.€€We€expect€to€be€working€on€this€study€for€approximately€one€year€and€will€collectÐ 8 ˆ Ðdata€from€at€least€11,000€Louisiana€citizens.€€Ð $ t Ðà  àYou€will€be€asked€to€answer€the€same€questionnaire€at€two€times:€today€and€one€monthÐ  ` Ðfrom€today€here€in€this€location.€It€will€take€you€about€30€Minutes€if€you€fill€out€the€form€yourselfÐ ü L  Ðor€about€45€minutes€if€you€are€asked€the€questions€by€the€research€assistant.€€Ð è 8  Ðà  àYou€are€under€no€obligation€to€participate€in€this€research,€it€is€your€choice€whether€to€beÐ Ô$  Ða€part€of€the€study€or€not.€You€may€decide€not€to€be€a€part€of€the€study€and€even€if€you€haveÐ À  Ðaccepted€the€questionnaire€and€have€begun€to€fill€it€out€you€may€stop€and€leave€the€study.€Just€Ð ¬ü  Ðreturn€the€unfinished€questionnaire€to€the€research€assistant€at€the€front€of€the€room.€There€will€beÐ ˜è  Ðno€bias€or€penalty€from€this€agency,€the€State€of€Louisiana€or€the€University€of€Louisiana€atÐ „Ô  ÐLafayette€if€you€decide€not€to€participate€or€if€you€decide€to€stop€participating€in€the€research.€€Ð pÀ Ðà  àThere€is€no€particular€benefit€to€you€if€you€participate,€but€the€researchers€may€learn€whatÐ \¬ Ðhelps€the€people€of€Louisiana€to€participate€in€research.€This€project€may€allow€important€researchÐ H˜ Ðto€be€done€for€the€people€of€Louisiana€in€the€future.€The€major€risk€to€you€is€inconvenience€inÐ 4„ Ðhaving€to€come€back€to€this€location€two€times€and€taking€up€your€time€filling€out€the€forms.Ð  p Ðà  àThe€results€of€this€research€will€be€published€in€a€professional€journal€after€it€has€beenÐ  \ Ðcompleted€but€no€personal€information€about€any€of€the€people€who€were€included€will€be€part€ofÐ øH Ðany€of€the€reports.€The€forms€you€are€filling€out€today€and€the€form€you€will€complete€in€oneÐ ä4 Ðmonth€will€be€destroyed€after€all€the€data€has€been€entered€into€analysis.€There€is,€as€you€may€haveÐ Ð  Ðnoticed,€a€number€on€each€page€of€each€of€the€forms.€€These€numbers€will€be€used€to€keep€theÐ ¼  Ðtwo€sets€of€forms€together€for€matching.€€Please€do€not€place€your€name€in€any€place€but€on€theÐ ¨ø Ðfront€of€the€booklet€of€forms.€€When€you€have€filled€out€the€second€form€we€will€give€you€backÐ ”ä Ðyour€front€page€to€keep€or€destroy€as€you€see€fit.€€From€this€you€will€know€that€we€do€not€haveÐ €Ð Ðyour€name€on€file€with€your€forms.€€If€you€have€any€questions€about€this€research€or€yourÐ l¼ Ðparticipation€in€the€study€you€are€welcome€to€call€Dr.€Alpha€at€482„1234€and/or€Ms.€Beta€482Ð X ¨ Ð3456€€at€UL€at€€Lafayette.€€We€will€make€every€effort€to€answer€your€questions.Ð D!” ÐÌò òCONSENTó óÐ #l! ÐI€understand€that€I€am€participating€in€research€and€that€the€research€has€been€explained€to€me€soÐ $X" Ðthat€I€understand€what€I€am€doing.€€I€understand€that€I€may€stop€participating€at€any€time.Ð ô$D # ÐÌSigned€òò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€óó€€Dateòò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€Ð Ì&"% ÐÌóóWitness€òò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€óóRelationship€if€anyòò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€Ð ¤(ô#' ÐÌóóReason€for€witnessing€the€form€(ex:€unable€to€read,€signs€with€ð ðxðð)òò€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€Ð |*Ì%) ÐÌ€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€óóÐ T,¤'+ Ð