There are 6 forms currently in use: the directions for study form and family information sheet are for information purposes only. The informed consent form must be completed by each study participant who chooses to enroll in our research study as a requirement of our Institutional Review Board. We would also like to obtain a completed participation data sheet and physician information sheet by each participant. If you are not able to get the physician information sheet completed at the time of enrolling in the genetic study then please complete the medical release form. This will enable us to obtain a copy of your/your patient's clinical records.
This form contains tick boxes detailing what is provided in your participation package and describing what needs to be undertaken before the salivary specimens or blood tubes and forms should be sent to our lab.
The Informed Consent Form is approved by our Institutional Review Board and must be read and signed before we can undertake testing on your samples.
Primary consent form
Below is a brochure to provide further information on research participation for patients seen at Boston Children's Hospital. Also there is a consent form to be completed and signed by each research subject prior to commencement of the research study.
Brochure for Boston Children's Hospital participants
Consent form for enrollment at Boston Children's Hospital
Participation Data Sheet
This form is for completion by each study participant and will provide us with general information pertaining to your contact details and description of your family tree.
Physician Information Sheet
This form is to be taken to your ophthalmologist for completion when you have your next appointment.
Medical Release Form
This form is to enable our obtaining detailed clinical information from your ophthalmologist and/or other medical records.