Case Report Consent Form Template
Simplify Patient Consent for Your Case Reports
Gathering informed consent for your case reports shouldn't be a hassle. This template streamlines the process for researchers like you, ensuring clarity and compliance. With the right case report consent form, you can effectively protect patient rights, enhance trust, and facilitate ethical research practices, while ensuring your documents are WCAG-aligned for accessibility. Start utilizing this template today and keep your research compliant and patient-friendly.
When to use this form
Use this consent when you plan to publish a patient case in a journal, present it at a conference, or share it in teaching materials. It helps clinicians, educators, and administrators document permission, privacy choices, and allowed uses before writing or uploading content. Collect it during intake or the pre-procedure visit, especially if you will capture photos or video. If the case involves infusion therapy, keep clinical treatment consent separate by pairing this with the IV Therapy consent form. The outcome: clear authorization, fewer delays with editors or ethics reviewers, and protection for both the patient and your organization.
Must Ask Case Report Consent Questions
- Do you give permission to publish details of your case for education or research?
This establishes clear permission and the intended purpose, which reduces confusion and legal risk. It also reassures patients that commercial use is not implied unless you specify it elsewhere.
- How would you like your identity protected (anonymized, initials only, or full name)?
Capturing the preferred level of de-identification sets expectations for names and images. It helps your team consistently apply privacy safeguards across drafts and media.
- Which materials may we use: medical history, images, videos, or lab results?
Granular consent prevents over-sharing and streamlines approvals. It lets you include only what is necessary for the case narrative.
- Where may we share your case (journals, conferences, websites, social media)?
Distribution channels affect visibility and risk. Getting this upfront avoids re-consent later if you change platforms.
- Do you understand you may withdraw consent at any time before publication, and how to do so?
Explaining the process respects patient rights and builds trust; if needed, direct patients to the Withdrawal of consent form. It also gives staff a clear procedure if a patient later opts out.
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