Submit Your Interest
Submit Your Interest
How your information will be used if you complete this form
This information was created by the CANAssess team at CTRU. We are carrying out the CANAssess study, which is ethically-approved research in the public interest. As part of this, if you are interested in taking part, we would like to collect your GP Surgery name, your full name, phone number, email address (if you have one), and the number you were given at the top of your invitation letter (Screening ID), if you received a letter. This is so a researcher can call you to discuss the study with you in more detail. If you have a carer who would like to take part, we would like to collect their full name, phone number, and email address (if they have one).
It is important that you know the following things about how your information will be used if you complete this form.
Click on each header to find out more:· This study and collection of this data has been approved
Collection of this data has been approved by the Research Ethics Committee London-Surrey. The University of Leeds and the University of Hull are jointly responsible for what data is collected, what it is used for and making sure it is used correctly and legally (this means they are called ‘joint data controllers’).
The data you submit in this form will be seen by researchers at the University of Leeds, University of Hull, Sunderland University and Primary Care Sheffield. A researcher from one of these organisations that is local to your GP Surgery will then be in contact with you. The researcher will contact your GP Surgery to let them know that you have responded to their invitation.
We will not use your contact details for any other purpose than contacting you to discuss taking part in the CANAssess study.
This form collects the data that we need to be able to contact you, such as your full name, phone number and email address (if you have one). We will collect your GP Surgery name to confirm that you are registered at a Surgery that is taking part in CANAssess. We will collect the number written at the top of your invitation letter (screening ID), if you received a letter, to confirm your eligibility for this study. Each eligible person at a GP Surgery taking part in CANAssess will have their own unique screening ID. If you do not know your screening ID number, please leave this blank, and we will collect this from your Surgery directly using your full name.
By ‘carer’ we mean a person who is close to you who provides you with support, this may be a friend, relative or neighbour. Carers employed to look after you will not be able to take part. If your carer would like to take part, we will ask you to state if you are happy for us to contact them, and if so, we will ask you to provide their full name, phone number and email address (if they have one).
The data you submit in this form will be held for a maximum of 3 months. If you are registered onto the study, your data will be stored as per the Participant Information Sheet and Carer Information Sheet for a minimum of 5 years.
· We will not share this data with anyone other than CANAssess researchers.
If you are not interested in taking part, please contact your local researcher using the details on this website to let them know. You will not be able to tell us you are not interested in this form.
This data is being used for approved research in the public interest. Research in the public interest has special protection in the law to make sure it is reliable. People who the data is about cannot ask us to delete, remove, access or amend their data, because this might make the research less reliable. We will nonetheless treat all data we have extremely carefully, and make sure we comply with all aspects of the laws about data protection.
If you have any questions about how your data are used, or would like to report a problem, please contact the University of Leeds Data Protection Officer:
- Email: DPO@leeds.ac.uk
- Postal address for data protection issues: University of Leeds, Room 11.72 EC Stoner Building, Leeds, LS2 9JT
- Telephone number: +44 (0)113 243 1751
For more about how data are used at the Leeds Institute of Clinical Trials Research and who to contact in case of a problem, go to https://ctru.leeds.ac.uk/privacy/