The iConquerMS™ Kids and Teens assent form can be found below. This is the information minors are asked to agree to, while registering for iConquerMS™ Kids and Teens.
It is necessary for a parent or guardian to provide informed consent and a child to assent before participating in any research.
The document below describes iConquerMS™Kids and Teens and what your role will be. Please read carefully to ensure you fully understand the initiative before joining.
Click here to download a printable PDF version of the assent information.
ASSENT FORM
For children ages 7-12
| TITLE: | A Multiple Sclerosis Patient-Powered Research Network, iConquerMS™ |
| PROTOCOL NO.: | ACP-MS-PPRN-001 WCG IRB Protocol # 420140400 |
| SPONSOR: | Accelerated Cure Project for Multiple Sclerosis |
| INVESTIGATOR: | Robert McBurney PhD Accelerated Cure Project 460 Totten Pond Rd, # 420 Waltham, MA 02451 |
| STUDY-RELATED PHONE NUMBER(S): |
Daytime Telephone Number(s): 844-897-1211 24-hour Contact Number(s): 844-897-1211 |
Taking part in this research is voluntary. You may decide not to participate, or you may leave the study at any time. Your decision will not result in any penalty or loss of benefits to which you are otherwise entitled.
If you have any questions, concerns, or complaints or think this research has hurt you, talk to the research team at the phone number(s) listed in this document.
RESEARCH CONSENT SUMMARY
You are being asked to be in a research study because you have a disease called multiple sclerosis (MS) or your family member does.
You can say yes or no to being in the study. No one will be upset and your doctor won’t change how they treat you if you say no.
You can ask as many questions as you would like before you decide.
Why is this study being done?
The study may help scientists learn more about multiple sclerosis.
Who else is in this study?
About 20,000 kids and adults will be participating in the study.
What happens to me if I agree to be part of this study?
- You will create an account at a website called iConquerMS using an email address and a password.
- Every so often, we will tell you about an activity you can do at iConquerMS like answering questions about living with MS or other things about your health or life.
- You don’t have to participate in any activity you don’t want to.
How long will I be in this study?
You’ll be in this study until you are a grown-up. When you are that old, we will ask you again if you want to continue to be in the study.
Could being in this study hurt me?
You might feel funny about some of the questions we ask. You don’t have to answer any questions you don’t want to.
Will being in this study help me?
Being in the study might not help you. We hope that this study will help scientists learn things that can help other children and grown-ups with MS.
Do I have to be part of this study?
No! You don’t have to be part of this study even if your parent or guardian want you to. You can say no and no one will be upset. Your doctor will still treat you the same. And you can say yes now but change your mind later. All you have to do is tell your parent that you don’t want to be in the study anymore.
Click on the box below if you would like to be part of this study.
Click on the box below if you would like to be part of this study.
☐ Yes, I want to be part of this study.