Beneficence - Protecting Human Subject Research Participants

Consent Document 1Respect for PersonsConsent Document 1Surface Antigen Expression in TrypanosomesDr. XYou are invited to participate in this study by giving blood on a voluntary basis, but no more than fivetimes in an eight week period. The research project is anticipated to continue for four years.All blood draws will be performed by qualified technicians at the Medical Center Blood Bank. 100 ml ofblood will be withdrawn from a vein in your arm.Although you will not benefit directly from participating in this study, you will make a major contribution tothe information known about trypanosomiasis, also known as sleeping sickness. In the future, others maybenefit because scientists and doctors will learn about how parasites cause sleeping sickness, and willdevelop vaccines to prevent it.You will be paid $5 for the time and travel required to give blood.Your signature on this form means that you understand that participation is voluntary, and you maywithdraw from the study at any time._________________________________________Signature of ParticipantContact information for Dr. X:Email: drx@university.eduphone: 123-456-7890http://phrp.nihtraining.com/respect/consentDocument1.php (1 of 2)6/20/2008 2:24:15 PM