Att_13 Clnic Exam Informed Consent Summary

Clinical Exam
Informed Consent Form Summary
You will be asked to read and sign an informed consent form on the day of your exam. Below you will find
a summary of the information in the consent form.
What you will be asked to do:
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Provide blood, hair, toenail, saliva, and urine samples
Have your vital signs and body measurements taken
Complete lung function tests
Complete tests of nervous system function
Complete a questionnaire about your health

Length of the exam: The exam takes about 4 hours to complete.
Payment to participants: You will receive a gift card for $100 for completing the exam and will be
reimbursed for your travel based on your distance from the clinic.
Costs: There are no costs to you other than your time and effort to participate in the study.
How your information will be used: What we learn from your exam will help us learn more about the
health effects of the Deepwater Horizon oil spill. All of the information you provide will be kept confidential
and will only be used for research purposes.
Results of tests: You will be given results on your blood pressure, heart rate, body mass index, lung
function test, and diabetes and cholesterol screening. If your results are abnormal, we will give you advice
about seeking medical care.
Benefits: You will not receive any direct health benefits from participating in the exam. However, you may
feel a sense of pride in helping researchers answer questions about the oil spill that matter to clean-up
workers and affected communities. You may also benefit from receiving the results of medical tests and
health care referrals for abnormal results.
Risks: The exam involves very minimal risks. Some of the questions we ask may make you
uncomfortable. There is a small risk of bruising or infection at the spot where the blood sample is drawn.
The lung function test may cause coughing, increased heart rate, and a feeling of lightheadedness that go
away shortly after the procedure. There is also a slight risk of accidental breach of confidentiality; we will
take steps to minimize these risks.
Confidentiality: Every effort will be made to protect the information and samples you provide. The GuLF
STUDY has a Certificate of Confidentiality that helps protect your information, but there is no guarantee
that we will not have to disclose your information in some circumstances.

Version 2.0 (07/19/2013)

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U.S. Department of Health and Human Services  National Institutes of Health  National Institute of Environmental Health Sciences