CENTRO ESCOLAR UNIVERSITY

Manila*Makati*Malolos
Research and Evaluation Office

INFORMED CONSENT

Research Title:

Purpose/s:

Procedure/s: Name Discomfort/ Risks Recovery Time

Benefits/Compensation:

Subject-participant shall: (1) receive adequate and immediate medical treatment should complication
arise; (2) receive full and adequate compensation and indemnification in case harm or injury arise out
of participation; and (3) be free to withdraw his/her consent and to discontinue participation in the
research anytime without prejudice to him/her and no explanation is required.

The researchers shall: (1) answer at anytime, any inquiry of subject-participant concerning the
procedure; (2) preserve anonymity and respect full confidentiality; and (3) be fully responsible and
accountable for all complications, injury, compensation, and the like to subject-participant as a result of
any or all of the procedures.

SUBJECT-PARTICIPANT
Name: Date:

Address:

Birthday: Signature:

Parent’s/Guardian’s Name and Signature:

RESEARCHER/S
Name Participation Signature Date

Copies to: Researcher(s); Research and Evaluation Office

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