Policy and Procedures
For Students

Informed Consent

If the project requires the use of written informed consent, the IRB suggests that researchers adapt, as appropriate, the following sample forms (MS Word format). Please avoid the use of jargon and technical terms, writing in lay language suited to an eighth grade reading level and using a font size large enough to enable the participants to read the form easily.

If you have any questions, please contact the Chair of the IRB: Dr. Kimberly Wear (336-841-9246)


Sample Consent Forms

Sample Consent Form Appropriate for Adults

Sample Consent Form Appropriate for Parent/Guardian Permission

Sample Consent Form Appropriate for Children





Contact Us

Chair of the IRB: Dr. Kimberly Wear
(336) 841-9246



Complete each section of the appropriate form (no handwritten forms). Email the form and any supporting documentation necessary to Signatures should be scanned and included as part of the electronic submission if possible.

The PDF versions of these forms are best viewed with Internet Explorer. If the content in the form does not load, please save the file to your computer and open it with Adobe Reader.

Consent Templates

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