Module C

Informed Consent

Version tracking · e-signature · witness · NGS separate consent

Consent rate: 94%

DL-NBS-042-001

Consent Form Version *

Please select a consent version.

Study ID *

Parent/Guardian Name *

Guardian name is required.

Relationship to Newborn *

Please select relationship.

Language of Consent Administered *

Please select language.

Consent Status *

Please select consent status.

Draw or upload

Signature is required.

Draw your signature using mouse or touch, or upload an image.

Witness Name

Required if participant is non-literate.

Witness Signature

Optional

NGS Consent Status *

Please select NGS consent status.

NGS Consent Date

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