ConsentForm

CONSENT FORM

Institutional Review Board for Baylor College of Medicine and Affiliated Hospitals

IMAGINE Research Program: Toward Precision Medicine at Baylor College of Medicine

H-52758 – IMAGINE Research Program: TOWARD PRECISION MEDICINE AT BAYLOR COLLEGE OF MEDICINE

Concise and Focused Presentation

The purpose of this research study is to learn more about the genetic and biological causes of different health conditions and diseases. Taking part in this study is voluntary. As an alternative, you can choose not to take part in this study.

If you choose to participate, you will be asked to give us permission to collect and use your samples (e.g., blood or saliva) and data. Samples can be collected from your routine clinical care or through a research visit/research draw. The data from your samples will be linked to the information in your medical record existing now and in the future. The collected samples and information will be stored and available for use indefinitely, or until you choose to withdraw your participation. There are no costs to you, and you will not get paid to participate. If you are a student, participating in this study will not impact academic performance. If you are an employee of Baylor College of Medicine or one of its affiliates, participating will not affect your employment status. While there is no direct benefit to participants, you may receive results about your genetic risk for certain conditions that are of clinical relevance to you or your family that could be impactful to current or future health matters.

The risks to you may include potential bruising or discomfort related to blood draw, learning your genetic testing results may cause emotional distress or uncomfortable feelings, and there is a potential loss of privacy. We take many steps to protect your information, but as with any research study, there is always a chance that your identity could become known. However, the study personnel will make every effort to minimize these risks. You may not get any direct health benefits from taking part in this study. We hope what we learn from this study will help us understand the causes of a range of medical conditions and develop new and more effective treatments.