(to be completed by the young person and their parent/guardian)
The information you provide is all we need to identify your NHS records - you do not even have to provide your home address as we can get this from the information you do tell us
I have read and understood what SHARE is about and I agree to join the SHARE Register
If you decide to join SHARE you are agreeing to allow us to use the coded data in your various NHS computer records to check whether you might be suitable for research projects about health. If you are suitable we will contact you to let you know about relevant studies. Once you hear more about any study you will have the opportunity to decide whether to take part.
We are also asking for your permission to store any spare blood left over from routine clinical tests to be used for research purposes in conjunction with the general SHARE register. This will allow us to find new ways to improve the safety and the effectiveness of drugs to combat disease.
I agree to the storage /study of my blood that remains after routine clinical testing.
If you decide to allow the use of your blood, any future blood taken by your GP or in hospital for clinical reason will be stored under the auspices of the appropriate tissue bank. Research teams will then be able to apply to study this blood and your coded NHS data without having any access to your identity. You will be free to withdraw from this bioresource at any time and your sample will be destroyed and data removed from the register upon request.
SHARE will try to contact you by phone, email or post. Please provide all relevant information.
It is useful to know how many times a year we can contact you. Please tell us the maximum times in one year you would like us to let you know about any suitable health studies:
I agree to the following Terms and Conditions and would like to join the SHARE register
I agree to the storage and study of my blood that remains after any routine clinical testing.