Dear Elgreat Healthcare Center Patient:
Thank you for choosing Elgreat Healthcare Center for your medical care. Elgreat Healthcare Center Providers and patients participate in various clinical trials and studies to help improve disease understanding, treatments, and symptom management. When a new research opportunity is available, our providers review it carefully to determine whether it might benefit our patients. If the providers believe that the research study could be beneficial to our patients, we identify which Elgreat Healthcare Center patients may be eligible to participate in the study. Once we identify these patients, we contact them to give them an opportunity to learn more about the study. The patient then chooses whether to participate. If you do not want to be contacted about opportunities to participate in research studies, please complete this form and return it to the office of your provider. If you do not complete this form, we may contact you about participating in research studies in the future. Whatever you decide, Elgreat Healthcare Center will honor your wishes and your current and future care will not be affected in any way.
Your consideration is appreciated.
The Providers of Elgreat Healthcare Center.
DISCLAIMER: By typing your name below, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.
Your information will be encrypted.
Your browser does not support capabilities required for electronic signatures.
Click a signature you want to use: