MRI Data Request

CHBH personal MRI data requests

Please submit the following information and someone will contact you regarding your MRI data request.

Title (Mr, Mrs, Miss, Ms)

First Name

Last Name

Your relationship with the University of Birmingham. Please state if you are a current or former member of staff or student.

Staff or student ID number (if applicable)

Date of Birth

Address

Address Line 1

Address Line 2

Town / City

Postcode

County

Country

Please describe what MRI data you are requesting and what the data will be used for (this will help us to provide data in appropriate format)

Please let us know the approximate date of your scan and the name of researcher who performed your MRI scan