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Short Form Consent English OLD

Instructions: See Appendix A-10 of HRP-103 Investigator Manual for information about using this form. Edit/Remove all highlighted text from the document before using with subjects. IMPORTANT INFORMATION: This document must be written in your language CONSENT FORM TO PARTICIPATE IN RESEARCH-SHORT

Iskra I Ivanova, MD

Iskra I Ivanova, MD, Clinical Assistant Professor

Kimberly Seyer, PA-C

Kimberly Seyer, PA-C specializing in Neonatology

Sathish Mallenahalli Chikkabyrappa, MD

Sathish Mallenahalli Chikkabyrappa, MD, Attending Physician, Assistant Professor, Pediatrics

Danny Olivera, CRNA

Danny Olivera, CRNA specializing in Anesthesiology

Katherine Casey Golden, ARNP, MPH

Katherine Casey Golden, ARNP, MPH specializing in General Surgery

Lawrence Sagin Wissow, MD

Lawrence Sagin Wissow, MD, Director, Child and Adolescent Psychiatry and Behavioral Medicine

Erin E Charles, MD

Erin E Charles, MD specializing in Hospital Medicine

Shannon Wagner Simmons, MD, MPH

Shannon Wagner Simmons, MD, MPH, Acute Mental Health Services Medical Director, Psychiatry and Behavioral Medicine Unit, Associate Professor,...

Kristina A Toncray, MD

Kristina A Toncray, MD, Medical Director, Patient Safety; Associate Vice Chair for Quality and Safety, Clinical Associate Professor