ÐÏà¡±á>þÿ =@þÿÿÿ<ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿì¥Á[ ð¿àbjbjZYZY 4"83b83b¥ 7ÿÿÿÿÿÿ·4 4 °°ÿÿÿÿ8L$p-ŒŒ(´´´d d d ´,¶,¶,¶,¶,¶,¶,//¶å1j¶,d B B "d d ¶,°°´´ŽË,¨!¨!¨!d ‚°´°8´´,¨!d ´,¨!¨!r’*Tèn+´ÿÿÿÿÐÌë Óÿÿÿÿæ Ræ* ,á,0-ô*zO28!pO2n+n+&O2”+d d ¨!d d d d d ¶,¶,¨!d d d -d d d d ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿO2d d d d d d d d d 4 Bv: UNIVERSITY OF GEORGIA CONSENT FORM [TITLE OF THE STUDY] [INSTRUCTIONS: A short form consent is used if a subject does not speak in English or in a language where there is a translated version of the full consent form, or if the subject is illiterate. See HRP-091- Documentation of Informed Consent (Sections 3.5 and 4.3) for policy and procedures on the use of the short form consent. THIS IS ONLY PROVIDED AS A TEMPLATE – ENGLISH SPEAKING SUBJECTS MUST SIGN A FULL IRB-APPROVED ENGLISH CONSENT FORM.] You are being asked to participate in a research study. Before you agree, the investigator must tell you about (i) the purposes, procedures, and duration of the research; (ii) any procedures which are experimental; (iii) any reasonably foreseeable risks, discomforts, and benefits of the research; (iv) any potentially beneficial alternative procedures or treatments; and (v) how confidentiality will be maintained. Where applicable, the investigator must also tell you about (i) any available compensation or medical treatment if injury occurs; (ii) the possibility of unforeseeable risks; (iii) circumstances when the investigator may halt your participation; (iv) any added costs to you; (v) what happens if you decide to stop participating; (vi) when you will be told about new findings which may affect your willingness to participate; and (vii) how many people will be in the study. If you agree to participate, you must be given a signed copy of this document and a written summary of the research. The main investigator conducting this study is [principal investigator’s name], a [professor; add graduate/undergraduate student name, if applicable] at the ³Ô¹ÏºÚÁÏÍø. Please ask any questions you have now. If you have questions later, you may contact [principal investigator’s name] at [email address] or at [phone number]. If you have any questions or concerns regarding your rights as a research participant in this study, you may contact the ³Ô¹ÏºÚÁÏÍø Institutional Review Board (IRB) Chairperson at 706.542.3199 or irb@uga.edu. Your participation in this research is voluntary, and you will not be penalized or lose benefits if you refuse to participate or decide to stop. 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