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Follow these steps to write an effective consent form. Step 1: Title and introduction. Step 2: Description of the activity. Step 3: Risks and benefits. Step 4: Confidentiality and data handling. Step 5: Voluntary participation and withdrawal. Step 6: Consent statement. Step 7: Signature and date. Step 8: Contact information.
Documenting peripheral I.V. therapy date and time of insertion. the type, length, and gauge of the catheter inserted. the name of the vein cannulated. number and location of attempts. the type of dressing applied to the site. how the patient tolerated the procedure. your name and credentials.
I agree to take part in [describe what involvement the individual will have e.g. an interview] and for the information I provide to be shared with the [area] Partnership agencies and this in turn allows services that I use to share information about me and my family for the purpose of this [research / activity].
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