Consent to Participate

By submitting this consent form, you are not waiving your legal rights or releasing the investigator(s) or involved institution(s) from their legal and professional responsibilities.

______________________________________________________________________

I agree to take part in a research study on COVID19 immunity being conducted by Prof. Brian Dixon, Prof. M. Aucoin, and Colleagues of the Departments of Biology and Chemical Engineering, University of Waterloo.

I have made this decision based on the information I have read in the Information letter. All the procedures, any risks and benefits have been explained to me. I have had the opportunity to ask any questions and to receive any additional details I wanted about the study. If I have questions later about the study, I can ask one of the researchers (Brian Dixon, bdixon@uwaterloo.ca or M. Aucoin, maucoin@uwaterloo.ca).

I understand that I may withdraw from the study at any time without penalty by telling the researcher. 

This study has been reviewed and received ethics clearance through a University of Waterloo Research Ethics Committee (ORE # 42840). If you have questions for the Committee contact the Office of Research Ethics, at 1-519-888-4567 ext. 36005 or ore-ceo@uwaterloo.ca.

For all other questions contact Prof Brian Dixon at 519-888-4567 ext. 32665 or bdixon@uwaterloo.ca


Are you YOUNGER than 18 years of age?
Are you on medication that can affect immunoglobulin production e.g., immunosuppressants, steroids (used to treat common conditions such as asthma, inflammatory bowel disease, arthritis, etc...), Tegretol and phenytoin?
Do you have a medical condition that cause low levels of immunoglobulin, specifically: kidney disease, diabetes, and malabsorption syndromes?
Any unused samples may be of benefit to other researchers. Do you give permission to have your contact information shared so that you can learn more about these research opportunities?