Theriome Informed Consent Form for Aristotle Metabolomics Test
Thank you for considering participating in the Aristotle metabolomics test, which is being offered by Theriome. This form contains important information about the test/service, including its purpose, what participation will involve, and any risks and benefits associated with participation. Please read this form carefully and ask any questions you may have before deciding whether to participate.
The purpose of this test/service is to provide you with information about your health by analyzing your blood samples. The analysis will be performed by Theriome using advanced techniques to measure the levels of various metabolites in your blood. The information obtained from this test/service may help you to better understand your health, identify potential health risks, and make more informed decisions about your healthcare.
If you agree to participate in this test/service, you will be asked to provide a small blood sample using a fingerstick method. The blood sample will be collected on a dried blood spot (DBS) card, which will be sent to the laboratory for analysis. You may also be asked to provide some basic demographic and health-related information.
There are minimal risks associated with this test/service. You may experience some discomfort or pain at the site of the fingerstick, but this is usually minor and temporary. There is also a small risk of infection or bruising at the site of the fingerstick.
There are potential benefits associated with this test/service. The results may provide you with valuable information about your health, including identifying potential health risks and helping you to make more informed decisions about your healthcare. This information may also be helpful for your healthcare provider in developing a personalized treatment plan.
All information collected during this test/service will be kept strictly confidential. Your personal information will not be shared with any third parties without your express consent. The results of the test/service will be provided to you and may be shared with your healthcare provider if you choose to do so.
Participation in this test/service is completely voluntary. You may choose not to participate or withdraw your consent at any time without penalty. Refusal to participate or withdrawal of consent will not affect your relationship with Theriome or your healthcare provider.
If you have any questions about this test/service or wish to withdraw your consent, please contact Theriome at email@example.com.
I have read and understand the information provided in this Informed Consent Form. I have had the opportunity to ask questions and all my questions have been answered to my satisfaction. By signing below, I voluntarily agree to participate in this test/service.