Mobile Health Study Data Use Consent Form
Please review the information below and provide your consent to participate in the mobile health study and for the use of your data.
Participant Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number (optional)
Please enter a valid phone number.
Format: (000) 000-0000.
Study Information and Data Use
I confirm that I have read and understood the study information above. I voluntarily agree to participate and allow the use of my data for research purposes.
*
I agree to participate and allow the use of my data.
Signature (optional)
Submit Consent
Submit Consent
Should be Empty: