THE HSWAGATA BUDDHA TOOTH RELIC PRESERVATION PRIVATE MUSEUM
FOR INTERNAL USE ONLY
Template No.: TK-043 (E/C)
Template Title: Testing Proposed Without Consent — Consent Forms & Consent-First Testing Rule
Related Research Case IDs / Cluster: Cluster E (Science/Testing/Misinformation) + Cluster C (Institution-Building/MoUs)
Linked Templates / Policies:
TK-046 Scientific Testing Request & Ethics Checklist
TK-051 Relic Testing MoU & Data Governance Sheet
TK-053 External Institution Verbal Clarification Record
TK-058 National / Institutional Testing Policy Alignment Sheet
TK-042 Lay Complaint & Rumour Intake Record (if public complaint)
Date of form: ____ / ____ / ______
Prepared by / Role: _______________________
Office / Unit: ____________________________
Country / Location: _______________________
Confidentiality Level:
Internal only [ ] Restricted [ ] Sacred-Restricted / Sensitive [ ]
Use of this form (tick):
New case / action [ ] Follow-up [ ] Annual review [ ] Archive only [ ]
TK-043 — Consent-First Testing Rule (Core Rule)
Rule: No testing may begin, and no sample may be taken, moved, photographed for lab use, or shared with a lab unless written consent is complete and the Board (or delegated authority) approves.
Consent must be:
Written (not only verbal).
Informed (clear about risks, limits, and outputs).
Voluntary (no pressure, no threats, no “secret testing”).
Traceable (who consented, when, what exactly was approved).
If consent is missing or unclear: STOP and record the case here.
A. Incident Record: Testing Proposed Without Consent
A1. Basic Information
Case title (short): ______________________________________________
Date reported: ____ / ____ / ______
Reported by: _______________________ Role: _______________________
Where proposal happened: ☐ Museum ☐ Temple ☐ Lab ☐ Online ☐ Other: ________
A2. What was proposed (tick all that apply)
☐ Non-invasive test (photo analysis / scanning / microscopy without contact)
☐ Contact-based test (swab, touch sampling, scrapings)
☐ Material removal (chip, drilling, cutting)
☐ Chemical test / solvent
☐ Transport to lab
☐ DNA / Carbon-14 claim
☐ “Just a quick check” informal testing
☐ Other: ______________________________________________
A3. Who proposed the testing
Person / institution name: ________________________________________
Contact: ________________________________________________________
Reason given (exact words if possible):
A4. Consent status (current)
☐ No consent requested
☐ Consent requested but not provided
☐ Verbal consent claimed only
☐ Consent form incomplete
☐ Consent given by wrong person / unclear authority
☐ Consent exists (attach) but scope unclear
Explain briefly:
A5. Immediate risk level
☐ Low (discussion only, no action taken)
☐ Medium (pressure, deadlines, or reputational risk)
☐ High (attempted sampling, removal, or covert action)
Reason: _________________________________________________________
A6. Immediate action taken (must tick at least one)
☐ STOP order given (no testing allowed)
☐ Item secured and access limited
☐ Board / Compliance informed
☐ Written clarification sent to proposer
☐ Security incident note made (if needed)
B. Authority Check (Who Can Consent?)
Consent is valid only if signed by a recognized authority, such as:
☐ Legal owner / registered custodian
☐ HSWAGATA authorized custodian (by appointment letter)
☐ Board-authorized representative (with written delegation)
☐ State authority (only if legally required and aligned with Board)
Name of consenting authority (if known): ____________________________
Proof of authority seen? ☐ Yes ☐ No
Type: ☐ ID ☐ Letter ☐ Registration ☐ Other: _____________
C. Consent Form Pack (Attach or Complete)
C1. Required Documents (minimum)
Tick when complete:
☐ C-01 Consent Form (Custodian/Owner Consent)
☐ C-02 Testing Scope Sheet (what exactly will be done)
☐ C-03 Risk & Respect Notice (religious and physical risk)
☐ C-04 Data & Image Consent (photos, scans, storage, sharing)
☐ C-05 Publication Consent (what can be published, what cannot)
☐ C-06 Withdrawal & Stop Rights (right to stop at any time)
C2. If any box is not ticked: testing is not allowed.
D. C-01 Consent Form (Custodian / Owner Consent)
Name: ___________________________
ID / Passport (last 4 digits only): __________
Address / contact: ____________________________________________
Relationship to relic / object: _________________________________
I confirm I have legal/recognized authority to consent: ☐ Yes ☐ No
I agree / do not agree (circle one) to the testing described in C-02.
I understand:
testing is limited to the agreed scope,
results may be uncertain,
the relic must be treated with respect,
I can stop the process if the agreed rules are not followed.
Signature: ___________________ Date: ____ / ____ / ______
Witness (HSWAGATA staff): ___________________ Signature: ___________
E. C-02 Testing Scope Sheet (What Exactly Is Allowed?)
E1. Test type requested: _______________________________________
E2. Invasiveness level: ☐ No contact ☐ Contact only ☐ Material removal (normally not allowed)
E3. Location: ☐ On-site ☐ Off-site lab (requires extra approval)
E4. Handling rules:
☐ No removal of material
☐ Gloves required
☐ Two-person rule (never alone with relic)
☐ Full documentation (photos + chain log)
E5. Time window: From //_____ to //_____
E6. Approved lab / team names: __________________________________
E7. Any forbidden actions (write): ________________________________
Approved by Department Head: _______________ Date: //_____
Board / delegated approval: ________________ Date: //_____
F. Consent-First SOP (Do This Every Time)
Stop and record any testing proposal in writing.
Confirm authority: who can consent? (Section B)
Explain clearly: what will happen, what will not happen.
Use the consent pack (Section C). No shortcuts.
Board approval before any lab contact becomes “active.”
Chain-of-custody + two-person rule during any handling.
Right to stop: if rules are broken, stop immediately and document.
G. Outcome / Decision
Decision: ☐ Rejected ☐ Paused pending consent ☐ Approved with limits ☐ Escalated
Reason (short): ________________________________________________
Next steps (short): _____________________________________________
Assigned officer: _____________________ Date: ____ / ____ / ______
H. Sign-off & Archive
Prepared by: __________________________ Signature: ________________
Reviewed by (Head/Compliance): __________________ Signature: ________
Date: ____ / ____ / ______
Archive code / file location: ______________________________________
