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Revised VA Consent and Authorization Templates

March 23rd, 2015

As of March 1, 2015, the VA Consent and Authorization Templates have been updated in accordance with the November 12, 2014 version of VHA Handbook 1200.05. Revised templates are on the Health Sciences Forms & Templates page.

VA Consent Template Summary of Changes

  • The header information has been shortened.
  • The verbatim language in the “To Potential Participants” section and the “Research Participants’ Rights” section has been deleted.
  • A section has been added for investigators to disclose applicable financial conflicts of interest. 
  • Text has been added to the Confidentiality section regarding use of photographs, videos, and/or audio recordings for research purposes.  Use of a separate form (VA 10-3203) to obtain consent for use of photographs, videos, and/or audio recordings is no longer required.

VA Authorization Template Summary of Changes

  • VA Form 10-0493 is the newest version of the authorization form as required by the VA.  This form must be completed by the investigator an attached in ERICA for review. Investigators must ensure that information in the authorization form is consistent with information in the consent form.

All new studies submitted as of March 1, 2015, are required to use the new templates. All studies submitted and/or approved prior to March 1, 2015, may continue to use the previous templates.

If you have questions regarding any of these forms, please contact the VA Research Office at 801-584-1271.

 

Last Updated: 2/23/20