Pediatric

Pediatric/Assent Form

Age-appropriate consent for studies involving minors. Includes separate parent/guardian permission and child assent sections written in developmentally appropriate language.

9 sections
5-6 minutes
Free template

About This Template

The Pediatric/Assent Form template addresses the unique requirements of research involving children and adolescents. It combines parent or guardian permission with a child-friendly assent section that explains the study in simple, age-appropriate language.

This template includes nine sections covering parent information, study explanation, activities, risks, potential benefits, privacy, voluntary nature of participation, the child assent section itself, and contact information. The language shifts appropriately between the parent-facing and child-facing portions.

The child assent section uses simple words and short sentences, explaining what participation means in terms children can understand. It emphasizes that participation is the child's choice and that they can stop at any time without consequences.

Designed to meet IRB requirements for pediatric research while ensuring both parents and children can make informed decisions, this template is essential for any study enrolling participants under 18.

Ideal For

  • Pediatric clinical trials
  • School-based research
  • Developmental studies

Sections in This Template

How Participants Will See It

This is a preview of the complete consent form experience participants will see.

Your Information

Please provide your contact details

Acknowledgments

Please confirm you understand the following

Electronic Signature

Please sign below using your mouse or finger

Signature Area

Participants draw their signature here

Your signature will be securely stored with a timestamp for compliance purposes

Get Started

Free template
Fully customizable
Electronic signature ready
Age-appropriate language