FORM OF CONSENT

TO RECEIVE NEWSLETTER AND PARTICIPATION IN FUTURE RESEARCH


The Vaccines Trials Group, part of the Wesfarmers Centre of Vaccines and Infectious Diseases based at Telethon Kids Institute, is involved in the development, evaluation and promotion of vaccines in our community for children and adults. We also participate in research to further understand why some children develop allergies or frequent infections. Information regarding your family will be kept on a confidential electronic database.

 

The Vaccine Trials Group preferred method of correspondence is via email. If you do not provide an email address you will not be able to receive the e-newsletter and all correspondence will be by postal mail.






Please enter all family members (under the age of 18 years) for whom you give permission to receive information. (Note: Only enter the name(s) of family member(s) for whom you are a parent or legal guardian):

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Please note: By clicking the 'I Consent' button below you are agreeing to be part of the Vaccine Trials Database. Participation in the Vaccine Trials Group database is voluntary and you can withdraw your consent at any time.