Oral Script to obtain Assent from Children 5-6 (after re

Approval Date: March 19, 2015
Approved Consent Version No.: 1
PI Name: Derek Cummings
IRB No. 00005474

P.I. Derek Cummings
IRB #5474

Version 12, March 16, 2015

Oral Script to Obtain Assent from
Children 5-6 (After return to school from absence)
Hi, my name is [interviewer’s name]. I am doing a study of the flu with the
University of Pittsburgh and Johns Hopkins University. Flu and other germs
make people sick. We were told that you were absent from school because
you were sick. We would like to take a swab of your nose to find out if you had
the flu or were sick with another virus. If you don’t want to do this, you can say
no at anytime. No one will be mad at you.
The swab that we take from your nose may hurt.
information that we collect from you private.

We will keep all the

Do you have any questions?
Do you agree to take part in the study?

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