The UK Malignant Hyperthermia Registry

I confirm that I have read and understand the Patient Information Sheet on the UK MH Registry website. I understand that inclusion of my details in the UK MH Registry is voluntary, and that my personal details will be stored securely. I understand that I am free to withdraw at any time without giving a reason. Only staff of the Malignant Hyperthermia Unit can look at my personal information in the UK MH Registry. I give permission to these staff to use my information to advise doctors looking after me or members of my family. I give my permission for information that is not identifiable information (such as name and date of birth) to be used for research that has been approved by the UK MH Registry and the relevant research ethics committee. I understand that if I withdraw then all identifiable information will be removed from ‘the UK MH Registry. The UK MH Registry will not release any of my personal information to external parties.

I confirm that I have read and understand the Patient Information Sheet on the UK MH Registry website. I understand that inclusion of my details in the UK MH Registry is voluntary, and that my personal details will be stored securely. I understand that I am free to withdraw at any time without giving a reason. Only staff of the Malignant Hyperthermia Unit can look at my personal information in the UK MH Registry. I give permission to these staff to use my information to advise doctors looking after me or members of my family. I give my permission for information that is not identifiable information (such as name and date of birth) to be used for research that has been approved by the UK MH Registry and the relevant research ethics committee. I understand that if I withdraw then all identifiable information will be removed from ‘the UK MH Registry. The UK MH Registry will not release any of my personal information to external parties.