What to Add in the Informed Consent Form & Participant Information Sheet
ANNEXURE 1 — PARTICIPANT INFORMATION SHEET (What to Add)
1. Correct Contact Details
- Replace "Ms. Shravanthi M" with the actual PI name: Ms. Poojitha N G
- Replace "Dr. Bharathi A, PT" with actual Co-Investigator: Mr. Pavankumar B N
- Fill in the mobile numbers (currently blank)
- Add the email ID: poojagowda178@gmail.com
2. Add Study Duration / Time Commitment
- Mention the total study duration (6 months) and that individual assessment takes 20–30 minutes — this is partially present but should be clearly stated under a separate heading "How Long Will It Take"
3. Add Right to Withdraw Section (Strengthen)
- Current text says "before submitting the survey" — this is wrong language for a clinical observational study (it's not a survey).
- Should read: "You may withdraw your child from the study at any time during the assessment without giving any reason and without any consequence."
4. Add Kannada Version
- The study is in Kolar, Karnataka. Parents of school children (6–12 years) may not read English fluently.
- A Kannada translation of the PIS must be added as required by Indian ethics guidelines (ICMR National Ethical Guidelines 2017).
- The current justification ("participants are physiotherapy students") is factually incorrect for this study.
5. Add What Happens to the Data
- Mention how long data will be stored (e.g., 3–5 years as per ICMR guidelines)
- Mention who will have access to the data
- State that data will be anonymized/coded before analysis
6. Add Study Registration / Ethics Reference
- Mention the IEC approval number (to be filled after approval)
- Optionally mention CTRI registration if applicable
7. Add Section on "What Happens if My Child Is Harmed"
- Even for non-invasive studies, ICMR guidelines require a statement that:
"Although no harm is anticipated, if any discomfort arises during the study, the child will be immediately withdrawn and appropriate support will be provided."
8. Add Dissemination of Results
- Add a statement such as: "The results of this study may be published in scientific journals or presented at conferences. No individual participant will be identifiable in any publication."
ANNEXURE 2 — INFORMED CONSENT FORM (What to Add)
1. Parent/Guardian Signature Block — MISSING (Critical)
Must add:
Name of Parent/Guardian: ___________________________
Signature of Parent/Guardian: ______________________
Date: ______________ Place: _______________
2. Name of Child — MISSING
Name of Child: ____________________________________
Age of Child: _____________________________________
3. Witness Signature Block — MISSING
Required by ICMR guidelines:
Name of Witness: __________________________________
Signature of Witness: _____________________________
Date: ______________ Place: _______________
4. Investigator Declaration — MISSING
The PI must also sign to confirm they explained the study:
I confirm that I have explained the study to the above participant's parent/guardian
and they have given voluntary consent.
Name of Investigator: _____________________________
Signature: _______________________________________
Date: _______________
5. Child Assent Section — MISSING
Since participants are children aged 6–12, a child assent is ethically required (verbal for younger, written for older children ≥7 years):
CHILD ASSENT (for children aged 7–12 years)
I understand that I will be doing some hand and touching tasks.
I agree to take part.
Child's Name: ____________________________________
Child's Signature / Thumb Impression: _____________
Date: ___________________
6. Strengthen Voluntariness Statement
Add explicitly: "I understand I can withdraw my child from the study at any point without any loss of benefit or penalty."
7. Correct "Digital Consent" Error
- Remove or correct the phrase "Digital informed consent mandatory" from the ethical considerations section — this is a paper-based consent study.
8. Add Kannada Version of Consent Form
- A Kannada translation of the consent form is required for the local parent population in Kolar.
QUICK CHECKLIST — Items Still Missing from Both Documents
| Item | PIS (Annexure 1) | Consent Form (Annexure 2) |
|---|
| Correct PI name & contact | ❌ Wrong name/blank number | — |
| Kannada translation | ❌ Missing | ❌ Missing |
| Parent signature block | — | ❌ Missing |
| Parent name field | — | ❌ Missing |
| Child name field | — | ❌ Missing |
| Witness signature | — | ❌ Missing |
| Investigator declaration/signature | — | ❌ Missing |
| Child assent section | ❌ Only mentioned verbally | ❌ Missing written form |
| Data storage duration | ❌ Missing | — |
| Right to withdraw (corrected) | ❌ Says "survey" | ❌ Not explicit |
| Ethics approval number | ❌ Blank | ❌ Blank |
| Harm/discomfort policy | ❌ Missing | ❌ Missing |
| Results dissemination statement | ❌ Missing | — |
Most Critical Additions (Priority Order)
- Parent/Guardian signature + name + date on consent form
- Child name on consent form
- Witness signature on consent form
- Investigator signature on consent form
- Correct contact details (right names + phone numbers) in PIS
- Kannada translation of both documents
- Written child assent for children ≥7 years
- Data storage and access statement in PIS