© 2019 by BHT Research & Innovation department.

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Stoke Mandeville Hospital

Mandeville Road

Aylesbury, Buckinghamshire

HP21 8AL

Tel: 01296 31 6065

Consent 4 Contact

'We would like everyone who attends Buckinghamshire Healthcare NHS Trust to have the opportunity to take part in a research study.'

There are studies in our hospitals which may be relevant to you now or in the future. If you consent to your details being stored on a secure database, we would be able to contact you to offer you the opportunity to participate when a relevant study arises.

Would you like to take part in research? It is straight forward to get involved!

HOW TO PARTICIPATE

If you want to hear about research which may be relevant to you.

1

FILL in your details below

2

WE will then record your details on our secure database

3

WE then send you information by post or email ONLY when a study is relevant for you

By filling in this form, you agree to your details being retained by the Research & Innovation Department at Buckinghamshire Healthcare NHS Trust for 5 years. For more information about how we will use your data in accordance with the General Data Protection Regulation (GDPR) that came into force on 25th May 2018, read the Health Research Authority (HRA) GDPR guidance here.