Documents

Files(27)

Name Size/Type Description Date
Cabazitaxel consent 113KB PDF Cabazitaxel consent 21 Apr 2020
Cabozantinib consent 113KB PDF Cabozantinib consent 22 Dec 2020
Caelyx (Liposomal Doxorubicin) consent 113KB PDF Caelyx (Liposomal Doxorubicin) consent 21 Apr 2020
Caelyx & Carboplatin consent 113KB PDF Caelyx & Carboplatin consent 21 Apr 2020
CAP consent 113KB PDF CAP consent 21 Apr 2020
Capecitabine + MMC consent 116KB PDF Capecitabine + MMC consent 01 Dec 2020
Capecitabine + Streptozocin consent 116KB PDF Capecitabine + Streptozocin consent 01 Dec 2020
Capecitabine + Temozolomide consent 115KB PDF Capecitabine + temozolomide consent 01 Dec 2020
Capecitabine consent 115KB PDF Capecitabine consent 01 Dec 2020
Carboplatin & Etoposide consent 112KB PDF Carboplatin & Etoposide consent 21 Apr 2020
Carboplatin + 5FU consent 117KB PDF Carboplatin + 5FU consent 13 Apr 2021
Carboplatin + Capecitabine consent 137KB PDF Carboplatin + Capecitabine consent 01 Dec 2020
Carboplatin consent 111KB PDF Carboplatin consent 21 Apr 2020
CAV consent 112KB PDF CAV consent 21 Apr 2020
Cemiplimab consent 112KB PDF Cemiplimab consent 21 Apr 2020
Ceritinib consent 111KB PDF Ceritinib consent 21 Apr 2020
Cetuximab & Encorafenib consent 114KB PDF Cetuximab & Encorafenib consent 20 Aug 2020
Cetuximab + Irinotecan MdG consent 116KB PDF Cetux + Folfiri consent 01 Dec 2020
Cetuximab + Oxaliplatin MdG (Folfox) consent 117KB PDF Cetux + Folfox consent 01 Dec 2020
Cetuximab, Carboplatin + 5FU consent 118KB PDF Cetuximab, Carboplatin + 5FU consent 13 Apr 2021
Cetuximab, Cisplatin + 5FU consent 118KB PDF Cetuximab, Cisplatin + 5FU consent 14 Apr 2021
Cisplatin & Etoposide consent 112KB PDF Cisplatin & Etoposide consent 21 Apr 2020
Cisplatin + 5FU consent 116KB PDF Cisplatin + 5FU consent 01 Dec 2020
Cisplatin + Capecitabine consent 137KB PDF Cisplatin + Capecitabine consent 01 Dec 2020
Cisplatin consent 111KB PDF Cisplatin consent 21 Apr 2020
Crizotinib consent 111KB PDF Crizotinib consent 21 Apr 2020
Cyclophosphamide oral consent 110KB PDF Cyclophosphamide oral consent 21 Apr 2020

Chemotherapy Consent Forms for Solid Tumours

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.