Doc Form Op-021501a "Informed Consent to Participate in Research" - Oklahoma

Form DOC021501A or the "Informed Consent To Participate In Research" is a form issued by the Oklahoma Department of Corrections.

Download a PDF version of the Form DOC021501A down below or find it on the Oklahoma Department of Corrections Forms website.

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INFORMED CONSENT TO PARTICIPATE IN RESEARCH
I, ___________________________ _ , ______________ , ____________________
(Name)
(DOC Number)
(Date Form Signed)
do hereby consent to participate in research by:
___________________________________ (Name or title and address of person
conducting the research)
___________________________________
___________________________________
Expiration date (if applicable) _______________________
AUTHORIZATION: I certify that the nature of this research project has been fully explained
to me, that I fully understand the details of my participation, and that this consent has been
made freely, voluntarily, and without coercion, after a fair and understandable explanation
of the nature of the research activity, the purpose, and the procedures to be followed.
__________________________________________________
(Inmate Signature)
_______________________________________________
(Witness)
DOC 021501A (R 8/18)
INFORMED CONSENT TO PARTICIPATE IN RESEARCH
I, ___________________________ _ , ______________ , ____________________
(Name)
(DOC Number)
(Date Form Signed)
do hereby consent to participate in research by:
___________________________________ (Name or title and address of person
conducting the research)
___________________________________
___________________________________
Expiration date (if applicable) _______________________
AUTHORIZATION: I certify that the nature of this research project has been fully explained
to me, that I fully understand the details of my participation, and that this consent has been
made freely, voluntarily, and without coercion, after a fair and understandable explanation
of the nature of the research activity, the purpose, and the procedures to be followed.
__________________________________________________
(Inmate Signature)
_______________________________________________
(Witness)
DOC 021501A (R 8/18)
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