Chemotherapy Consent Forms for Haematology

All consent forms on this website are for the use of St Luke’s Cancer Alliance staff in respect of St Luke’s Cancer Alliance patients only.
For those who do not work within St Luke’s Cancer Alliance:
Use of this site and any information on it is at your own risk. We do not accept responsibility for the use of any information that may be set out on the website. You assume full responsibility for the use of the information.  You may wish to take your own legal advice before using any of the consent forms.

Please note that the consent forms below are not tumour-specific; one consent form may be used to consent patients for more than one St Luke’s Alliance chemotherapy protocol which uses the same combination of chemotherapy.

These consent forms should act as an aide-memoire to health professionals and patients, by providing a check-list of the kind of information which patients should be offered, and by enabling the patient to have a written record of the main points discussed.

The relevant Macmillan/CRUK leaflet(s) should also be provided to each patient before consent. In no way, however, should written information given to the patient be regarded as a substitute for face-to-face discussions with the patient.