Change of Contact Details Form

This should be the name you registered under when you joined th DOMINO-DFU study.
This should be the phone number, email address or the postcode of the address that we have recorded as your contact details.
Enter a contact phone number, email, or full address
If your name has changed, enter your new one here.
Please note, the initials you registered when you joined the trial will remain unchanged as we use these for internal identification purposes.
Changing your name here will not change the name on your hospital records.

Privacy Information

This webpage was created by the team at the Clinical Trials Research Unit (CTRU), University of Leeds. The University of Leeds is 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 the ‘data controller’). The contact details you provide via this website will be stored securely in an email account and on a database at CTRU. Only CTRU staff working on the DOMINO-DFU study will have access to this information. After the end of the study, your data will be securely archived for a minimum of 15 years, arrangements to securely destroy the data will be made. We will only collect your contact details for the purposes of DOMINO-DFU and will only use it for this study and not for any other purpose. We will not share your contact details with anyone else.

If you have any questions about how your data is used, or would like to report a problem, please contact the University of Leeds Data Protection Officer DPO@leeds.ac.uk or University of Leeds, Room 11.72 EC Stoner Building, Leeds, LS2 9JT. If you have any questions about how your contact details are used, or access what information we hold about you, please contact DOMINO-Patients@leeds.ac.uk. You can also contact the University of Leeds Data Protection Officer. For more about how data is 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/.