Below are examples of consent forms created by eMERGE sites and authorized for use in past eMERGE studies.
Examples of Consent Forms Used in Pharmacogenomics Sequencing Research
- Cincinnati Children’s Hospital: Pre-emptive genotyping of children and adolescents at risk for surgery and subsequent pain management (Adult Consent)
- Cincinnati Children’s Hospital: Pre-eimptive genotyping of children and adolescents at risk for surgery and subsequent pain management (Assent form)
- Cincinnati Children’s Hospital: Pre-emptive genotyping of children and adolescents at risk for surgery and subsequent pain management (Parent Permission)
- Geisinger eMERGE PGx (Pharmacogenomics) Project Research Consent
- Group Health Research Institute/ University of Washington: eMERGE Pharmacogenomics Study
- Marshfield Clinic Research Foundation eMERGE PGx Project Consent Form
- Mayo Clinic Research: Right Drug, Right Dose, Right Time – Using Genomic Data to Individualized Treatment (Right Protocol)
- Northwestern University: A Pharmacogenomics Pilot Project in General Internal Medicine (Patients)
- Northwestern University: A Pharmacogenomics Pilot Project in General Internal Medicine (Physicians)
- Vanderbilt University: Informed Consent for eMERGE-PGx
Examples of Consent Forms Used in Genomic Medicine Pilot Studies and/or eMERGE Biobanking Research
- Marshfield Clinic Research Foundation: Research Consent/Authorization Form- Personalized Medicine Research Project
- Cincinnati Children’s Hosptial: Informed Consent for Participation in a Research Study
- Essentia Institute of Rural Health: Genetic Testing for Risk of Age-related Macular Degeneration
- Geisinger MyCode Community Health Initiative Research Consent
- Group Health Research Institute/ University of Washington/ Fred Hutchinson Cancer Research Center: Electronic Medical Records and Genomics Research eMERGE Study
- Mayo Clinic: Genetic Determinants of Peripheral Arterial Disease
- Northwestern University: NUgene: Gene-Disease Association and Treatment Outcomes
- Vanderbilt University: Consent for Treatment