IN THE STUDY Clause Samples

IN THE STUDY. This consent form contains important information to help you decide if you want to be in the study. If you have any questions that are not answered in this consent form, ask one of the study staff. Please answer YES or NO to the following questions:

IN THE STUDY. The overall experience of the ▇▇▇.▇▇ app enables users to earn points through their actions in the app. Points will be collected on an ongoing basis by the participant within the app. Cumulative points for this study will be 25,000 points (collected after the participant completes all study required procedures, including the final survey). Participants in this study who complete all the actions can convert these total 25,000 points to a one-time only ▇▇▇▇▇▇.▇▇▇ gift card of up to $250.00 in value through the link provided after the final survey. You will be offered a phone stand approximately $10 in value, if you need it. If you are invited to do the usability interview and complete the interview successfully, you will receive a one-time link for a total of $50, redeemable as a one-time ▇▇▇▇▇▇.▇▇▇ gift card. The principal investigator is an employee of ▇▇▇.▇▇ on whose app this study is being conducted and is being paid by the sponsor to conduct this research study.

IN THE STUDY. You might feel tired from the eye exams or study procedures. Also, the eye exams and measurements may pose risks because some devices come very close to or touch your eyes. There is a small chance that the instrument used could scratch the surface of your eye. If that occurs, it is usually minor. Also, you may experience blurred vision or discomfort from the numbing drop that the study doctor gives you. These could last up to 24 hours after the exam. Also, there is a risk of allergic reaction (itching, redness, burning, or mucous discharge) to the ingredients in the anesthetic (numbing) eye drop used in these evaluations. If experienced, this could last up to 12 hours. Because your eyes are numb, it’s important that you do not rub your eyes for at least 20 minutes after the exam. The orange-yellow (Fluorescein) dye that will be put in your eyes to evaluate the intraocular pressure (pressure inside your eye) may make your skin and bodily secretions and excretions, such as your tears or mucous, change color, or they may cause some irritation to your eyes. This effect is usually temporary and disappears within a day. Rarely, people can have an allergic reaction to fluorescein dye. This would usually involve itching, swelling, or redness. If you develop such a reaction, you will receive treatment. As with any allergy, more serious or life threatening reactions are possible. No adverse reactions (bad side effects) have been reported for the Canon HS100 OCT or Optovue RTVue XR devices. Because the Canon HS100 OCT device is investigational (not yet FDA-approved), all of its side effects may not be known. There may be rare and unknown side effects. You must tell the study doctor and staff if you experience any side effects. If you are not honest about your side effects, it may not be safe for you to be in the study.

IN THE STUDY. Part 1 (Cohorts 1-6) Payment Part 2 (Cohorts 7, 8, 9, and 10) Payment

IN THE STUDY. You may receive up to for being in the study. You will be paid per completed visit as follows: Screening Visit 1 Visit 2 Visit 3 Follow-up Telephone Call Total compensation for study completion will be up to for completion of all study visits and the

IN THE STUDY. I have read this consent form. I understand the purpose, procedures and risks as explained in this document. My questions have been answered to my satisfaction. I voluntarily agree to participate in this study. I know that I can stop participation at any time. I will be given a signed and dated copy of this agreement. Name of Study Subject (printed) Signature of Study Subject Date Name of Study Subject’s Partner (printed) – if applicable Signature of Study Subject’s Partner – if applicable Date I have discussed the research study with the subject and subject’s partner and explained to them in non-technical terms all of the information contained in this informed consent form, including any risks that may reasonably be expected to occur. I further certify that I encouraged the subject and the subject’s partner to ask questions and that all questions asked were answered. Printed Name of Person Explaining Consent Form Signature of Person Explaining Consent Form Date You will be given a signed and dated copy of this informed consent to keep.‌