OncoLink/NCCRA Database Consent

I understand:

• That I am registering into a database for consideration of involvement in future clinical trials.
• That these trials will be used for the possible prevention and treatment of colorectal cancer or study of familial risk factors.
• They are endorsed by the NCCRA.
• That any information I submit will be secure.
• That this secure information will be used to determine my eligibility to participate in clinical trials for colorectal cancer prevention and treatment.
• That submission of information to this database in no way obligates me to participate in any clinical trials.
• That I may withdrawal from participation in this database at any time for any reason.

I will allow:

• Representatives of the NCCRA to contact me regarding my eligibility to participate in future clinical trials.
• Representatives of the NCCRA to use the information I provide for an unlimited period of time.

If you have any questions about this study, consent form, or survey please feel free to contact us.