{# consent_table.html #} {% comment %} parameters: LEAFLET_URL_CPFTRD_CLINRES_SHORT patient_lookup settings {% endcomment %}
{% if patient_lookup.is_under_15 %} As {% else %} If {% endif %} you are under 16:
Thank you! |
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Parent or guardian: |
Name: | Signed: | Date: | |||
Clinician: |
Name: | Signed: | Date: | |||
If another adult is making decisions on your behalf:
Thank you! |
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Representative: |
Name: | Signed: | Date: | |||
Clinician: |
Name: | Signed: | Date: | |||
* Note to clinicians: for decisions about clinical trials, this must be the patient’s legal representative. For decisions about other research studies or the database traffic-light system, this must be the patient’s carer or consultee. For more details, see {{ settings.LEAFLET_URL_CPFTRD_CLINRES_SHORT }}. |