ࡱ> SURW bjbjzz 4eeI?MMMMMaaa8a=t$gMMM888^MM8888 F8 0=8 @| 8 M8p8|=  : SAMPLE TEMPLATE: SHORT FORM WRITTEN CONSENT DOCUMENT FOR SUBJECTS WHO DO NOT SPEAK OR READ THE ENGLISH LANGUAGE Consent to Participate in Research You are being asked to participate in a research study. Your participation in this research study is voluntary, and you will not be penalized or lose benefits if you refuse to participate or decide to stop. Before you agree, the investigator must tell you about (i) the purposes, procedures, and duration of the research; (ii) any procedures which are experimental; (iii) any reasonably foreseeable risks, discomforts, and benefits of the research; (iv) any potentially beneficial alternative procedures or treatments; and (v) how confidentiality will be maintained. Where applicable, the investigator must also tell you about (i) any available compensation or medical treatment if injury occurs; (ii) the possibility of unforeseeable risks; (iii) circumstances when the investigator may halt your participation; (iv) any added costs to you; (v) what happens if you decide to stop participating; (vi) when you will be told about new findings which may affect your willingness to participate; and (vii) how many people will be in the study. If you agree to participate, you must be given or offered a signed copy of this document and a written summary of the research. You may contact _________________________ at ______________________ any time you have questions about the research. You may contact the Institutional Review Board at the University of Denver Institutional Review Board at 303-871-2121 if you have questions about your rights as a research subject. Consent has been documented and witnessed, indicating approval or disapproval by another means and method (blinking of eyes, raising arm, etc.) as noted below, and that the research study has been described to you orally, and that you voluntarily agree to participate. ____________________________ ___________ ________________________ Name of Participant Date Method used for indicating approval ___________________________ ___________ Signature of Witness Date      app HRPP/IRB Short Form Consent, v1, Feb 2021 56CNpqrg   VWXhq񙌙reeeXeXeXehLH<hOJQJ^JhLH<hOJQJ^JhLH<hqsOJQJ^JhLH<hBKOJQJ^JhLH<h(OJQJ^JhLH<h OJQJ^JhLH<hC5OJQJ^JhLH<hq85OJQJ^JhLH<h[zX5OJQJ^J$hLH<h 5B* OJQJ^JphhLH<hqs5OJQJ^JhLH<h 5OJQJ^J"6qrf g + , WXefg-gd(gd $a$gd $a$gdqs!IJLMOPRSUVWXͰ hLH<hqsCJOJQJ^JaJhqsjhqsUhLH<jhLH<UhLH<hqsOJQJ^JhLH<hOJQJ^JhLH<hOJQJ^J-IKLNOQRTUWXe$a$gdqsgdqsgd 21h:p / =!"#$% ,EDd|  C XA@UniversityOfDenver_Signature(1)b\D%|3w8DD3n0D%|3wPNG  IHDR,bX pHYs+ IDATx]|TĂ.DĎ 'D  %)bAQT  bAv7۹{yZ.&\޾}$%)IIJR$%)IIJRhAJg1;+ϰ~f]$̺.}|ѩ/CBP ”"_;V,s_ 7So秴Wc2#h{dJLE"% @'I`e¶O@M?YX[ȒYW EWrRv@2M&d/_:k%LaLh''Z!9KhY䞒O ]ZsM]?_ &?)%)I5*s N)i)jXr٢ &ȲrgIZ(Se.w2^>ŸA.}Q_8lhY>V(-I>;Z#{ljc\rK̿ޑhԋ~[8 [{kl_)3%/HTVj&+Er鐜 |ĉ%(JNJcH!0|4^ˠsh7rYir&-8/wdza;wnDs:NGChzyOWʩ^q4cK+UU;b!-V{WIJҿ*tRh* FˆC}D+)U?I_ }9~Y;IɎ=$,5si E=ӫ=EܩPgPN(%:ڥI& Lcim|8mïT{|]-8^*<< iqH(qĎ)(KvV kWJR̀R-e)oߓ|-ΧWO_N~}@_Ǫv|Zr4OJ7v"SB ω؇FCs$$-!A""F4RADCD#zVW*aas饓ewo_m]{*Wii}O @VjIJRj9̚]Ći{~N?I5^SAsp<@ M\4&4a~'ʭi kAmsd_S@CDŽ c&ɱavW/>y2~t V7xXDߵ$%&#`j{OCNW/r{~+1cCv+ʑ'6I @,P` N*JmȔ%hn,>3z||I irH0:LI{Ү=CYRܯ m$0r^?Wo\et)tV 'v/'hh-[I>F InꍗAk,g jΨs:i~3 * LJluXBp8J Ӷvw+1#%ݸv~ J.>#~uc8hG$6P5iߓK_$%̸Up*U,ٔ{) prJ 9R]4i`;rB.ImY NTץ;4l Tj}N (Ui AkFԹ~L}?HXYة]$T$EX;7mU=ԃc q6~Q|}`' 4Хqϒ\C'2Pwɇ0.|=$*1 tst'K17e'Suݣis>EI>63v?D %$w uvzP#a='46k?ƚq9Lk>!΃Ϸc6|z^$ZZާT‡oB HcsH1.ʪi-WѴoLmj8iisEo :̩J\q0k@4NG䕒_>U'J\FɿH~Y zgC +69?U7_|䆒uz&K% IΓ䵺:}R+H#y>\ /}$I}۷[X1Ο%1Ƹ©Byc|n?&ևWs.8x:^~M`vc~. c!),0> `) F8TIFӞMfoI΢})kwU>4A䑿[&۶W[Ȱ֫UavZjCu‡s媿l_X |!Iݰ3h{.(TJhr[H#ǾVXvψs(1{tl:.t@k8TYg/BlzuF1D&]_rߐFuv fd룋1 `uTU!g@,齡yl@[\nմ.FK ,Q3Q_T D?]VWT$c{/YBS2y잱Qe0v7'Oh`  ;oe$ff+۵‹q4{iRY4m-4m 4j;iŗ*)`J:^-U>R@E)5VxZk ءP;`f2n7Ƕ_FlPvùa:q[Yez6:/[1QkF=6bײG8>ΰ 9ѡ{3}~M_;|VvmQQ®3&!`c6] `>/4ҧБڱⰪt1,賧귡3ݩ9ܰ(ʶe$**<(N'HXu0T^eW`Jrߝulz27Հ}uukKvn/Bo~xX j"0Q 33Kv Ge"pN]'nb+nw3А1IpW^Y)kw.$wY< Fu4+%ތkh﨤-xiYZ6%p4[H셏*ۘw{,+ XsEns'Dh0]mĨU*'zY醴: D X z,QYNd#'r{b,5YìiTYͽ;1̾o<7jԏ&`iU ٹ;Q ]ΣZ4OP,4\OGoFd`7[L<$>?M~fI)kr˔Xv;EX!"r/Xqݤh Ψ;vLs7yU_Lcک:ˤE`1GӜ!p^+*>QJ݀KNqV%95a)+~1ve ;S,xxH"]n?H,\<Kn_ AmiN#$̪AXr2mt<gJ :D[mhLT]e[/8."c&x՘ƾ_Eγ%E N3hfofH3&ܭx(a]Z/lr~I ~͞f8u"7`AFT|Ȍob#>7l3[?Uo;=N/C k t'} '*<.t#c ZxyMN2ϥ'~uDdzmuXA꣛t!lCunFQ,x؟#XU1KDTPW,F+t0}n{RO? }ɘvg7'Q$,_ ,Z7' uDR@*!X->!m%9N8fK4Xu͚0M?¢U~Neg?3BaWaU`gy_1`\_-Z?,7lfJXO cl'ڗ>|}Vcng qܓl1A׿ζ?]fz#?z.`lĄHֵRJ$.AV]Xè ǪZ3'OE(*<<9VW ,t\hkÀuMbi,7`m0uήxСnKs,]L~#k~ٌQ݀eޫEwE%ȧ6;,d|$3m$h4ђ?lCl# RZՀeJ?-USYIpϟ̥mϡB4 +Gg . =SXKa\3InDĆR~(8_ ZE)]ÃξT,}k7Pvc;MDXw[5im 5?U` ;ABFiը +_C?w?^O]~?m]yP~^Mӳս 0>D7_z N#lQ/;Xzcϲg:fL3T[0P}D`!5/ Xct=k?k%G6]gQcr-X9MDʐ X={}0<0؎U$`J mNȸZ4THrJӚ9*c. sPr M}V*ʾV %`ݯfk +n*+kvzpܤ=RMq,7c11F{ /=}ا0|jkK&z w  x~ҥ=cQsĮkBH0mW?`6{ :]qv^ X/~V.gbJ+<TXM/uz*c lZH|z T ʵ 6P!PATAV\jsYjl ԔnI 6>%#P(GMFbے= #)ĞqƉLAobȾ۴5AbcFE}LC3;'D ߙrfp@$[5狀* /# 2pc’piF Xؾx"'w:4oS,ar4aq(Dwj8\%[mUgT,ޗ |*+ǵ'?Aj](r|I]WѬ9(#)a /?J9;ɺK'9]IX3%VQ!G,̰O1qq 3]X_rG0,qRƂ&!}n <95t88$e RlmqpV>&ʷAǨj&<8wL~JXR!_VA#*(* 왟YwFI>m%1ӶVӧse4~GZfo@}&zR2j(5N7#LdƝiiv#Jšs%YܭGٜy)4vGZN'hlO [vs1HHuT-:Ve[f9AU'2 m#}5"yy99'/S4ckTϦ@!_R[~BVΛ1R.ު8Wl7?lOψ |&6$+i4t>HsZNo#O-7Z*{+MwGQ}i,+Ey^@_]~=/W RҔ 1x* K4`}FJXz4&97&Aj/it88subs?|G;6n+k>w5e 0#ha$,VNԙz IDATR;nl\j㷖 Ħoy6V;vnFO3Wڷa3-27MvHqd)Vy$aNt}]ƌD y,T q (͹º`25ìkYn < Xqx>ӰǴ=xm{=^;$,p=._岹ͼ#UXNJOӫ/fʹǴʶٟZЯ~I:_Af,vM rׯxv~:?|OoyDXXr x\n]` l,o;4xQ\?WY~Y8SNe:'+'bZq,xj>5Y03Q[fx!/f  4ÀzDkg5^dkc<9wcM:aK{ԿmD꺸'7"8)C<Ʋ-+xg}0WG vcM E5#H|@3#|`J[CE!-_]0Ap:NuQtn ʅV=Q^jf! 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