VA Form 10-1086
RESEARCH CONSENT FORM
Page 1 of 1
TITLE OF STUDY
DESCRIPTION OF RESEARCH BY INVESTIGATOR 1.Purpose of study and how long it will last: 2. Description of
study including procedures to be use:; 3. description of procedures that may result in disconfort or inconvenience:
4. Expected risks of study: 5. Expected benefits of study: 6. Other treatment available: 7. Use of research results:
8. Special circumstances.