You are being asked to read this information sheet because you are interested in getting involved in research at TGen. This registry helps connect us with interested volunteers.
This registry will request basic contact, demographic, and medical information. We will keep this information and use it to contact you in the future if you are eligible for one of our research studies. The information will be shared with TGen indefinitely. If you are contacted, you do not need to take part in any research study.
We will take precautions to protect your privacy. All personally-identifying information (such as a name) you share with us will be stored in a secure location with limited study personnel access.
There is no cost to participate in this registry and you will not be paid for sharing your information. There is no direct benefit if you agree to participate. Your alternative is not to participate.
For questions, concerns, complaints about this registry, or about a research-related problem, please contact the study coordinator at (602) 343-8653 or
crc@tgen.org. This research is being overseen by an Institutional Review Board (IRB). An IRB is a group of people who perform independent review of research studies. You may talk to them at (855) 818-2289,
researchquestions@wcgrib.com if you have questions about your rights as a research participant.
The study staff may share the records generated from this research with the sponsor, regulatory agencies such as the US Food and Drug Administration, Health and Human Services, and the IRB. The information is shared so the research can be conducted and properly monitored. The people receiving this information may not be required to protect it and your information may be re-disclosed without your permission. If you do not provide permission to use your information, you cannot be in the study.
Your decision to participate in this registry is voluntary. You will not be penalized or lose benefits if you decide not to participate. If you decide you would like us to remove your information from our registry, please contact a study coordinator at (602) 343-8653 or
crc@tgen.org.
Your completion of this form will serve as your consent to participate in this registry. If you do not want to participate, please do not submit the information on this form.