/Docs/./G/GA4GH/Demo/Study_Signatures
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Consent to Participate


Consent and Signature

Please read the information below, and sign if you agree.

I have been provided all the information I need to make a decision. I have been able to ask questions if I did not understand the information.

I agree:
  1. that my personal, medical and genetic data can be deposited in online, controlled-access scientific databases;
  2. that my data be studied by researchers from around the world;
  3. that I will not be identified in scientific publications and at conferences;
  4. that I will not receive any profits if commercially valuable product(s) result from these studies;
  5. that my data cannot be removed if it is already used in a dataset or published; and
  6. to give access to data from my stored tissues for study where applicable.


I know that participating is my choice. I understand that I may withdraw at any time without having to give a reason.

I agree to be re-contacted to update my data, or to be involved in new research projects:

Yes

I agree to be re-contacted if medical information is found that could be useful to me and my doctor:

Yes

Your email/address: roberta@robinsonandson.com

Signature: xROBERTA ROBINSON

Date November 7, 2014

Researcher Signature xALISON ANDREWS

Date November 7, 2014

Copy given to participant: YES!