Appendix E: Customizable Informed Consent Form/Script 

Acknowledgements

• Maureen Wimsatt, PhD, MSW, Center for Healthy Children and Communities, Inc., Paid Consultant
• Carly Raasch, MA, Center for Healthy Children and Communities, Inc., Paid Consultant
• Valerie Goodson, MPA, Council of State and Territorial Epidemiologists, Senior Program Analyst

The Reproductive Health and Disasters (RHAD) Assessment Toolkit 2.0 was adapted by Council of State and Territorial Epidemiologists (CSTE) from the Reproductive Health Assessment After DisastersToolkit.

CSTE thanks the RHAD Assessment Toolkit 2.0 Workgroup, the CSTE Maternal and Child Health Epidemiology Emergency Preparedness Capacity Assessment Workgroup and the U.S. Centers for Disease Control and Prevention, Division of Reproductive Health, Field Support Branch, Emergency Preparedness and Response Team. This publication was supported by the U.S. Centers for Disease Control and Prevention (Cooperative Agreement Number 1 NU38Ot000297). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.

All resources and links in this toolkit were updated and active at the time of release in December 2022.