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Informed Consent Form Templates

Centres should download and fill in the Patient Consent Form in the appropriate language for each of their patients, as the law requires that the patient consents to the data being transferred to the EBMT. 

EBMT shall provide the Informed Consent Form to the participating sites to be used for data reporting to EBMT. The reporting centre shall be responsible for ensuring that the Informed Consent Form is in compliance with applicable laws and meets the minimum requirements as indicated by the Informed Consent templates on this web page. No centre is exempt from obtaining patient consent before submitting data to the EBMT.

NOTE: The informed consent forms provided below are made up of 2 parts: the patient information leaflet and the Informed Consent Sheet with the tick boxes for patient consent. Centres are free to divide the document into two parts, if so desired, to facilitate patient comprehension of the document.

Croatian

Informed Consent Form(s)

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Informed Consent Form - Adults Download

Translation Certificate

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Translation certificate - Adults Download

Czech

Informed Consent Form(s)

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Informed Consent Form - Adults Download

Translation Certificate

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Translation certificate - Adults Download

Danish

Informed Consent Form(s)

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Informed Consent Form - Adults Download

Translation Certificate

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Translation certificate - Adults Download

Dutch

Informed Consent Form(s)

Document Download
Informed Consent Form - Parents Download
Informed Consent Form - Children 6-11 years old Download
Informed Consent Form - Children 12-17 years old Download
Informed Consent Form - Adults Download

Translation Certificate

Document Download
Translation certificate - Children and Parents Download
Translation certificate - Adults Download

English

Informed Consent Form(s)

Document Download
Informed Consent Form - Parents Download
Informed Consent Form - Children 6-11 years old Download
Informed Consent Form - Children 12-17 years old Download
Informed Consent Form - Adults Download

Estonian

Informed Consent Form(s)

Document Download
Informed Consent Form - Adults Download

Translation Certificate

Document Download
Translation certificate - Adults Download

Finnish

Informed Consent Form(s)

Document Download
Informed Consent Form - Parents Download
Informed Consent Form - Children 6-11 years old Download
Informed Consent Form - Children 12-17 years old Download
Informed Consent Form - Adults Download

Translation Certificate

Document Download
Translation certificate - Children and Parents Download
Translation certificate - Adults Download

French

Informed Consent Form(s)

Document Download
Informed Consent Form - Parents Download
Consent Form for Data Sharing with SFGMTC & EBMT* Download
Informed Consent Form - Children 6-11 years old Download
Informed Consent Form - Children 12-17 years old Download
Informed Consent Form - Adults Download

*  EBMT encourages to use this ICF for centres that wish to report HSCT data to EBMT and SFGMTC.

Translation Certificate

Document Download
Translation certificate - Children and Parents Download
Translation certificate - Adults Download

German

Informed Consent Form(s)

Document Download
Informed Consent Form - Parents Download
Informed Consent Form - Children 7-11 years old Download
Informed Consent Form - Children 12-17 years old Download
Informed Consent Form - Adults Download

Translation Certificate

Document Download
Translation certificate - Children and Parents Download
Translation certificate - Adults Download

Greek

Informed Consent Form(s)

Document Download
Informed Consent Form - Adults Download

Translation Certificate

Document Download
Translation certificate - Adults Download

Hebrew

Informed Consent Form(s)

Document Download
Informed Consent Form - Parents Download
Informed Consent Form - Children 6-11 years old Download
Informed Consent Form - Children 12-15 years old Download
Informed Consent Form - Adults Download

Translation Certificate

Document Download
Translation certificate - Children and Parents Download
Translation certificate - Adults Download

Italian

Informed Consent Form(s)

Document Download
Informed Consent Form - Parents Download
Informed Consent Form - Children 7-13 years old Download
Informed Consent Form - Children 14-17 years old Download
Informed Consent Form - Adults Download

Translation Certificate

Document Download
Translation certificate - Children and Parents Download
Translation certificate - Adults Download

Norwegian

Informed Consent Form(s)

Document Download
Informed Consent Form - Parents Download
Informed Consent Form - Children 6-11 years old Download
Informed Consent Form - Children 12-17 years old Download
Informed Consent Form - Adults Download

Translation Certificate

Document Download
Translation certificate Download

Polish

Informed Consent Form(s)

Document Download
Informed Consent Form - Parents Download
Informed Consent Form - Children 6-11 years old Download
Informed Consent Form - Children 12-17 years old Download
Informed Consent Form - Adults Download

Translation Certificate

Document Download
Translation certificate - Adults Download

Portuguese

Informed Consent Form(s)

Document Download
Informed Consent Form - Adults Download

Translation Certificate

Document Download
Translation certificate - Adults Download

Slovenian

Informed Consent Form(s)

Document Download
Informed Consent Form - Adults Download

Translation Certificate

Document Download
Translation certificate - Adults Download

Spanish

Informed Consent Form(s)

Document Download
Informed Consent Form - Parents Download
Informed Consent Form - Children 11 years old and younger Download
Informed Consent Form - Children 12-17 years old Download
Informed Consent Form - Adults Download

Translation Certificate

Document Download
Translation certificate - Children and Parents Download
Translation certificate - Adults Download

Swedish

Informed Consent Form(s)

Document Download
Informed Consent Form - Parents Download
Informed Consent Form - Children 6-11 years old Download
Informed Consent Form - Children 12-17 years old Download
Informed Consent Form - Adults Download

Translation Certificate

Document Download
Translation certificate - Adults Download