Participant T1 Permission

Participant authorisation form

First Name

Last Name

Your Email address

Date of Birth

I give permission for the following named researcher to have access to my MRI T1 scan taken previously at the CHBH (please give full name)

Researcher email address

By checking this following box, you agree for the above named researcher to have access to any MRI scan taken previously for any other study at the CHBH