Sample Assent Form for Children with Autism

  If you agree to take part in this research study, please read, tick and sign below.  

 

Child’s Name (Printed):……………………………………….…………………………
Child’s Signature:…………………………………………………………………………………

If your child cannot sign their name for any reason, they can tick/mark the following box to indicate they assent to taking part in this study:

Parent’s Name (Printed):……………………………………….…………………………
Parent’s Signature:…………………………………………………………………………………
Date:……………….…………………………………………………………………………………………………………………

 

Sample Assent Form for Children without Autism (Families with an Autistic Child)

  If you agree to take part in this research study, please read, tick and sign below.  

 

Child’s Name (Printed):……………………………………….…………………………
Child’s Signature:…………………………………………………………………………………

If your child cannot sign their name for any reason, they can tick/mark the following box to indicate they assent to taking part in this study:

Parent’s Name (Printed):……………………………………….…………………………
Parent’s Signature:…………………………………………………………………………………
Date:……………….…………………………………………………………………………………………………………………