

Name | Size/Type | Description | Date |
---|---|---|---|
Ipilimumab & Nivolumab consent | 113KB PDF | Ipilimumab & Nivolumab consent | 21 Apr 2020 |
Ipilimumab & Nivolumab mesothelioma consent | 291KB PDF | Ipilimumab + Nivolumab mesothelioma consent | 28 Feb 2024 |
Ipilimumab consent | 112KB PDF | Ipilimumab consent | 21 Apr 2020 |
Irinotecan consent | 112KB PDF | Irinotecan consent | 21 Apr 2020 |
Irinotecan MdG (Folfiri) consent | 115KB PDF | Folfiri consent | 01 Dec 2020 |
Ivosidenib consent | 113KB PDF | Ivosidenib consent | 28 Feb 2024 |
Kadcyla (Trastuzumab emtansine) consent | 112KB PDF | Kadcyla consent | 05 Jun 2020 |
Larotrectinib consent | 111KB PDF | Larotrectinib consent | 22 Dec 2020 |
Lenvatinib (Lenvima) consent | 113KB PDF | Lenvatinib (Lenvima) consent | 21 Apr 2020 |
Lomustine consent | 110KB PDF | Lomustine consent | 21 Apr 2020 |
Lorlatinib consent | 112KB PDF | Lorlatinib consent | 05 Jun 2020 |
Mobocertinib consent | 112KB PDF | Mobocertinib consent | 31 May 2022 |
Modified de Gramont consent | 115KB PDF | modified de gramont consent | 01 Dec 2020 |
Neratinib & Capecitabine consent | 156KB PDF | Neratinib & Capecitabine consent | 30 Jun 2020 |
Neratinib consent | 152KB PDF | Neratinib consent | 30 Jun 2020 |
Niraparib consent | 109KB PDF | Niraparib consent | 21 Apr 2020 |
Nivolumab consent | 112KB PDF | Nivolumab consent | 21 Apr 2020 |
Nivolumab relatlimab (opdualag) consent | 110KB PDF | Nivolumab relatlimab (opdualag) consent | 25 Apr 2024 |
Olaparib + Bevacizumab consent | 111KB PDF | Olaparib + Bevacizumab consent | 13 Apr 2021 |
Olaparib consent | 112KB PDF | Olaparib consent | 28 Apr 2023 |
Osimertinib consent | 110KB PDF | Osimertinib consent | 04 Feb 2021 |
Oxaliplatin + Capecitabine consent | 138KB PDF | Oxaliplatin + Capecitabine consent | 01 Dec 2020 |
Oxaliplatin MdG (Folfox) consent | 117KB PDF | Oxaliplatin MdG (Folfox) consent | 01 Dec 2020 |
Paclitaxel (weekly) consent | 112KB PDF | Paclitaxel (weekly) consent | 21 Apr 2020 |
Paclitaxel & Carboplatin consent | 134KB PDF | Paclitaxel & Carboplatin consent | 21 Apr 2020 |
Paclitaxel & carboplatin, EC with pembrolizumab consent | 118KB PDF | Paclitaxel & carboplatin, EC with pembrolizumab consent | 23 Dec 2022 |
Paclitaxel & Cisplatin consent | 113KB PDF | Paclitaxel & Cisplatin consent | 21 Apr 2020 |
Paclitaxel & Gemcitabine consent | 113KB PDF | Paclitaxel & Gemcitabine consent | 21 Apr 2020 |
Paclitaxel, Carboplatin & Epirubicin (TEC) consent | 113KB PDF | Paclitaxel, Carboplatin & Epirubicin (TEC) consent | 21 Apr 2020 |
Palbociclib consent | 112KB PDF | Palbociclib consent | 21 Apr 2020 |
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 leaflet(s) should also be provided to each patient before consent. In no way should written information given to the patient be regarded as a substitute for face-to-face discussions with the patient.
These consent forms are for solid tumour chemotherapy only, and are NOT to be used for chemo-radiotherapy regimens.