Consent Forms

Our research programmes provide a beacon of hope for the many children and adults battling Histiocytosis, to ensure this research continues we ask you to support the UK Histio Registry.
Thank you.

Consent Forms

Right click to download. 

Consent for adult with histiocytosis
Assent form child with histiocytosis
Consent form for parent or guardien of child with histiocytosis
Consent form for relative of deceased patient
UKHR Nominated Consultee Declaration V2.0
UKHR Personal Consultee Declaration V2.0

Please post the completed CONSENT FORM to:  

Sarah Pagan Project Manager
UKHR
M3.127, 3rd Floor Leech Building
Translational and Clinical Research Institute
Faculty of Medical Sciences
Newcastle University
Framlington Place
Newcastle upon Tyne 
NE2 4HH

Your support of Histio UK is vital to ensure that we can maintain the UK Histio Registry which an essential research resource.
Thank you.

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