Patient Consent Form — Example

Description

A detailed patient consent form that includes authorization for use of protected health information. The attached serves as a suitable example of patient consent for the purposes of a research study or pilot study of patient centered technologies.

Audience

For researchers, legal departments, program evaluators, and other program personnel.

Helpful Tips

The patient consent example was used in a randomized controlled trial of a medication adherence algorithm and remote patient monitoring technology.

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