IDEAS Study - Parental Consent Names and Signatures

Yes, I

1. Parent or Guardian Name - First and Last *This question is required.

have read the above information and give permission for my child,

2. Child's Name - First and Last *This question is required.

to participate in an interview for the IDEAS Study.

3. Student email address *This question is required. This question requires a valid email address.

4. High School Name *This question is required.

Parent's Signature Field

*This question is required.

Clear

Signature of

6. Date parent's signature *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

Please verify yourself via CAPTCHA

7. Please indicate which timeslot(s) you are available for a focus group. We will try to prioritize your availability when scheduling. *This question is required.

Tuesday, April 28 at 4:30pm MST/ 5:30pm Central
Wednesday, May 6 at 4:30pm MST/ 5:30pm Central