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Consent and Assent Templates

There are two sample Assent Forms - these document was borrowed with permission from the University of Massachusetts ? Amherst). They are included as guides to you in construction of an assent form to be used in your project.

The federal regulations that govern the protections of human research subjects state that adequate provisions must be made for soliciting the assent of children and the assent of adults with diminished capacity to consent, when, in the judgment of the IRB, the individual is capable of providing assent. Adequate provisions should also be made for soliciting the permission of each individual's parents or guardian. Assent should be received for children ages 7-17, unless the child's decision-making capacity is impaired, and from adults with diminished capacity to consent.

Fill in the appropriate information and adjust to the specifics of your research.


*Do Not include a statement to the effect that ?your parent/guardian has agreed to allow you to take part in the study?. This implies the possibility of pressure from the parent/guardian for the individual?s participation. Instead use ?your parent/guardian is aware of this project?.

*Make sure you use age appropriate language. For example, do not use the same language for a third grade student as you would someone in the 12th grade.

Minor Assent Form - Children 11 or younger or adults with more severely diminished capacity

Minor Assent Form - Children 12 -17 and adults with less severely diminished capacity

Consent Form - to be used by any individuals 18 years of age or older who are capable of providing consent

Parental Consent Form - to be completed by parent or legal guardian's of those under the age of 18 or those of any age with diminished capacity