Research & Clinical Trial Consent
Asks about participant name, study title & description, and study ID / protocol number. Built for clinical research sites and academic medical centers.
- Questions
- 12
- Pages
- 2
- Time
- about 3 min
Includes
- E-signature
- Consent agreement
Your practice
Research & Clinical Trial Consent
Page 1 of 2 · Your information
Live preview. Tap through it like a patient.
Who it is for
- Clinical research sites and academic medical centers
- Pharmaceutical company-sponsored trials
- Medical device studies
- University-based research programs
What's inside
Before you publish: Add your practice-approved consent wording before publishing.
Page 1 · Your information
- Participant NameText
- Date of BirthDate
- Study Title & DescriptionLong Text
- Study ID / Protocol NumberText
- Principal Investigator NameText
Page 2 · Additional details
- Emergency ContactText
- Research Participation ConsentConsent Agreement
- Right to Withdraw AcknowledgmentConsent Agreement
- Compensation DetailsText
- Participant SignatureE-Signature
From form to a ready patient

01
Make it yours
Reword, reorder, or add to the Research & Clinical Trial Consent, and add your logo.

02
Patients finish it at home
A secure link by text or email, filled out on their phone before the visit. No app.

03
Your team sees who is ready
Each visit shows as ready once its forms are in. Answers land on the patient record.
Related templates
All templatesClinical Trial Enrollment FormRegistration · 15 questions
Clinical Trial Site Billing Agreement FormBilling · 9 questions
Genetic Testing Consent FormConsent · 14 questions
High-Risk Medication ConsentConsent · 14 questions
High-Risk Medication Consent FormConsent · 12 questions
Organ Donation Consent FormConsent · 10 questions
Questions
Send it before the visit, so patients arrive ready.
Add the Research & Clinical Trial Consent to your account and make it yours in a few minutes.
Cancel anytime · BAA included