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Unformatted text preview: I voluntarily agree to donate my personal health information for incorporation in this study. I understand that I may withdraw my materials from this study at any time without penalty or prejudice. I understand that: Adequate safeguards will be provided to maintain privacy and confidentiality of my health information. The study is anonymous. My name will not be used to identify any personal information reported. My individual health information will not be reported; rather, aggregate data will be reported. There are minimal risks associated with this study. There is no compensation for donating my health information to this study. The principal investigator has described the study. The principal investigator has answered all my questions. ______________________________ _________________________ (participant signature) (investigator signature) ___________________________ _________________________ (date) (date)...
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