Patient's consent for de-identified research and sample storage
American University has been selected to participate in a COVID-19 research study conducted by the Smithsonian Institute of Medical Research (“Smithsonian”). The Smithsonian will study COVID-19 positive samples collected during COVID-19 testing to study COVID-19 variants. Individuals who test positive for COVID-19 may have their samples forwarded to the Smithsonian to participate in the research study. The sample provided will be de-identified and stored for further research to support medical and academic research related to health, disease prevention, drug development, and related scientific research.
By acknowledging below, I am voluntarily seeking laboratory testing services and hereby consent to provide my COVID-19 positive sample(s) for research purposes. I understand that I/my child will receive no compensation in connection with such research.