邢唷��>� ;=��:��欹�[ ��bjbj*�*� :.H�bH�b� �� 8�D��n,,,,,=??????$,��!c�c��,,�x��:�,�,=�=��,��袐頶"弦��A��)�0��"�p�"��"��D�cci|��" BN: IRB CONSENT FORM TEMPLATE: Please substitute the boldfaced sections with simple, clear, and grammatical English. All elements must be included but should be modified in language and content appropriate to your research and your subjects. To Project Participant: You are invited to take part in a research project entitled, [Project Title], conducted by [name of Principal Investigator and Institutional affiliation, e.g., 揓oan Smith at 黑料不打烊 (BCC)擼. In this study we hope to learn more about [subject of study]. You were selected to participate in this study [explain selection process]. We hope that our research will lead to [reasonably expected benefits to subject or others]. [Describe what the subject will be expected to do. State the duration of the subject's participation. If there is to be any compensation, state the compensation.] [Describe the risks involved, discomforts, or inconveniences. If a potential risk is a loss of confidentiality, you must explicitly say so. If psychological and/or physical risks are involved, these must also be explicitly communicated. Should participation in this research project result in an adverse event, an enrolled/eligible student may seek basic mental health care within the scope of the services of the staff of the Student Counseling Center, during normal operating hours, or see a personal/outside health care provider for care and treatment. For care beyond the scope of services at BCC, such as physical injury or illness, subjects must seek care and treatment from an outside/personal health care provider. In all cases, in the event of need for emergency medical care, call 911. Any and all incurred health care costs associated with participation in this research project are the responsibility of the subject. If a medical or mental health treatment is involved in this research project, and as a consequence the subject wishes to withdraw from the study, briefly describe alternative interventions.] Reports resulting from this study will not identify you as a participant. All information gathered in this study will remain confidential and be given out only with your written permission or as required by law. [Briefly explain the method of confidentiality, e.g. by numbered cross-references or by keeping the files locked up. Consent forms, audio/videotapes, numbered cross-references and data should be kept in separate locked locations. Indicate how long files will be kept before being destroyed; the minimum requirement is three years following completion of the study. If the Principal Investigator is a student, files must be kept in the advisor抯 or other department office, although anonymous data files may be used at the student抯 home during the project period. Explain exceptions to the protection of confidentiality, where applicable. For example, under Massachusetts law we are obligated to report any abuse that we encounter or reasonably suspect regarding children and the elderly. This mandate also applies to expressed intent to commit harm to another that we encounter or reasonably suspect.] If you have any questions about this research at any time, please contact [Principal Investigator] at [phone number, email address and street address. Also list any other appropriate names and contact information, e.g., Faculty Supervisor and/or Other Investigator(s).] By signing this consent form you indicate that you have read the form and agree voluntarily to participate in the study. If you choose not to take part, there will be no penalty or loss of benefits to which you are entitled. If you agree to take part, you are free to withdraw from it at any time. Likewise, no penalty or loss of benefits to which you are otherwise entitled will occur. I agree to participate in [Project Title], as set out above. ____________________________ _________________ Signature Date THIS PROJECT HAS BEEN REVIEWED BY THE BERKSHIRE COMMUNITY COLLEGE INSTITUTIONAL REVIEW BOARD FOR THE PROTECTION OF HUMAN SUBJECTS IN RESEARCH. ADDITIONAL CONCERNS AND COMPLAINTS, OR QUESTIONS REGARDING YOUR RIGHTS AS A RESEARCH PARTICIPANT, SHOULD BE DIRECTED TO THE IRB CHAIR, MARGARET STEPHENSON, AT 413-236-2117. 0GK�> H I R V Y g o 蝈蛴怜煆煆焵teXHt€8hF]h�W5丆JOJQJ^JhF]h��5丆JOJQJ^JhZ�5丆JOJQJ^JhF]h��CJOJQJ^Jh��CJOJQJ^JhF]h�WCJOJQJ^JhQIhT6丆JOJQJ^JhQIh�W6丆JOJQJ^J"hQIhrM�5�6丆JOJQJ^J"hQIh�W5�6丆JOJQJ^J"hQIh5jZ5�6丆JOJQJ^Jh��5丆JOJQJ^Jh5jZ5丆JOJQJ^J�� kl��45DE��8KL��$�<��<�a$gd頪� $ �*$a$ $ �*$a$gd5jZo x y � � � � � � M f � � � � � � COhjlmz��蝈杖划日熣熣熣煇諂諂諂諓諓諂誵d諂誨�h� 5丆JOJQJ^Jh��5丆JOJQJ^J"hIfOh�W5�>*CJOJQJ^Jh碍笔补��24飞词赌�蜮意棱扁もも椻眿鈤鈗鈤鈤鈤鈤产盫扁丑+碍�颁闯翱闯蚕闯镑闯丑*CJOJQJ^JhF]hO H5丆JOJQJ^JhF]h�W5丆JOJQJ^Jh)l55丆JOJQJ^J!�� #%,ADE��L]襻葬袢峄敗呩駓駆\咇Mh�?�hVCJOJQJ^JhF]h�$5丆JOJQJ^Jh�$5丆JOJQJ^Jh*CJOJQJ^JhO Hh�WCJOJQJ^JhV�5丆JOJQJ^JhK�5丆JOJQJ^JhL5丆JOJQJ^Jh秞r5丆JOJQJ^Jh+K�CJOJQJ^Jh+K�5丆JOJQJ^JhF]h�W5丆JOJQJ^JhF]h�WCJOJQJ^J]�SV��疋峡ˉˉˉ…h3hjh3hU"h頪�h�WCJOJQJ\乚乛Jh頪�B*CJOJQJ^Jph%h擳�hVB*CJOJQJ^Jphh�?�hVCJOJQJ^Jh�?�h�?�CJOJQJ^J��$�<��<�a$gd頪� 800P靶/ 班=!癭"癭#怈$�%�盃靶愋Dp�s02�� 0@P`p€��2(�� 0@P`p€�� 0@P`p€�� 0@P`p€�� 0@P`p€�� 0@P`p€�� 0@P`p€�8X�V~��€�� 0@�� 0@�� 0@�� 0@�� 0@�� 0@�� 0@�� 0@�� 0@�� 0@�� 0@�� 0@�� 0@�� 0@_HmH nH sH tH <�`�<�NormalCJ_HmH sH tH DA ��DDefault Paragraph FontVi��VTable Normal :V�4�4� la�(k ��(No ListPB@�P Body Text$ �*$a$OJQJtH uH�H�(+Balloon TextCJOJQJ^JaJB' �B眞�Comment ReferenceCJaJ8"8眞�Comment TextCJ:��1:眞�Comment Text CharLj!"L眞�Comment Subject5乗乵HsHtHF�/�QF眞�Comment Subject Char5\4b4D€Header �H�$2�/�q2D€Header CharCJ4 �4D€0Footer �H�$2�/��2D€0Footer CharCJ.X ��.頪�Emphasis6乚丳K!檗�[Content_Types].xml瑧薔�0E鱄鼉�-J湶@%閭菐洽|廊�$韶钵UL襎B� l,�3鳛;鉹�得槣B+$�G]ミ7O侪V墎�c:菜�E3v@釶莮�憇� |煓w�<�<爔k猴ll5� 玈Z埣2O,辜帣Q績� €‰壪�5y�;y=卐E颎翼帊|\P疼鞭M7�$|n]�枌蓢]4忥`窾6涀G冼(垲�^斗菹颻琖��-翻関]m蓿瓄�  飍祡缧暺}攙旯缦r�鍧竔倲崜0�� D3劂梋閐�3譙钐嚟�耳杧:忲�8}d-楀鉯*壵x上轻qCよZ}�柣WlшqyI@赹剟6橧!Q_� ﹪s殔刏賩a汛癶H魉Tm�jyV`垆纅�榾惫�<箣犇鼁YpL8�*аx侏S&机;EUC�8⒊eE�<В悟hg贇!燴H睩x0� VM螽憆刳u�6拺覦s�3 U慮赢b��6�怂5y嵳2臓iz嘜]r汯璠�'鋆炃弦u涎4jj採�K臀F娃盶�晕�$4寨-莓�-�珠`餜�熘��&藑代觥瀈A<吼"xNW﹦� � 袬鞩R賭[鋺萵 8r� i箯K~�*~P(5黕莲z胦Wm忒杮~乖鞹濦caT鲇�.}x E僮5抉&Z緄�2bQ懇/,EE\}�)W�乹埼鉠ミ�6;礏弛�糿h礜贻~7�威�9R`痌糧疩〞儬嗾J拁▄旿郢�=$燮朗Sb酻紇��PK! 褠煻'theme/theme/_rels/themeManager.xml.rels剰M �0匃倃oo雍�&輬协�勪5 6?$Q祉 �,.嘺緳i粭澤c2�1h�:闀q毩m胳嶡RN壻;d癭値o7�g慘(M&$R(.1榬'J摐袏T鶂�8V�"＆A然蠬鱱}狇�|�$絙{�朠�除8塯/]As賲(⑵锑#洩L蔥汉倪��PK-!檗�[Content_Types].xmlPK-!ブх�60_rels/.relsPK-!ky��theme/theme/themeManager.xmlPK-!稝��theme/theme/theme1.xmlPK-! 褠煻'� theme/theme/_rels/themeManager.xml.relsPK]� �.�� o �� B�]� ��8�@��€€€�饞��0�( � �養 �S�� ?��5Y��dta o � � ] f ��] a � &L�=O��33333333333333n��n��'耯1&VLl*�$諮3UD_F慿GO HQIN4IIfOuS�!TV�WfWLkWX餑X5jZF]"^]鴑abK�)�坢��3E�]��1s�蟇�苢�8�V�-�燝�I��9��.�䓖�眞�擳�{�7&��?�+K��Z��rM�5-�鶹�~�;S�3��!�=B�Wv���K��穖�PI�筆�恅�w�{&�餦�I��€1Table��"WordDocument��:.SummaryInformation(��*DocumentSummaryInformation8��2CompObj��r�� F Microsoft Word 97-2003 Document MSWordDocWord.Document.8�9瞦