Informed Consent Form

A copy of the form will be sent to your e-mail inbox after signing.

This form describes in detail how the study works and what your role is.

Your signature means you understand and you agree to participate.

649-962-4811

649-962-0140

bic9008@med.cornell.edu

  1. This study aims to advance understanding of progression and management of lower urinary tract symptoms through patient-generated real-world data. They may not be a direct benefit to you.
  2. This study comprises both prospective collection and retrospective collection of data. You can opt in/out of each. The duration of your study participation will be determined based on your decision to opt into the prospective collection only or the retrospective collection only or both.
  3. Participation is voluntary. You can decline to participate in the study, leave the study or stop sharing your data at any time.
  4. The study staff will work to keep your data confidential and secure.
  5. Risks of participation include the possible loss of confidentiality of your information.
  6. Your alternative is to not to participate in this study.
  1. I have been informed about this study’s purpose, procedures, possible benefits and risks.
  2. I read the explanatory note on the consent, thoroughly understood the contents, and am conscious of the fact that the study is performed for the research purpose.
  3. My decision of participation is voluntary and I understand that I can reject or withdraw my continuity of participation anytime due to personal reasons during the study and I would not suffer any disadvantage.
  4. I can always ask the Investigator or the Study Support if I have any questions regarding the study. Hereupon, I agree to participate in the study according to my voluntary intention.