The Recipient Contact Information Form 2820 collects contact information on recipients who have agreed to be contacted directly by CIBMTR for the purpose of inviting them to participate in research activities. If the recipient is a minor, contact information for the parent or legal guardian will be collected. Contact information for an alternate contact is collected if participation in a specific study requires it.
The Form 2820 becomes due in one of two ways.
- Consent Tool, “Did the recipient give permission to be directly contacted by CIBMTR for future research”, is answered “yes.”
- The patient is enrolled in a clinical trial (e.g. BMT CTN or RCI BMT) that includes a patient reported outcome (PRO) component. When the patient is enrolled the enrollment form triggers Form 2820 to become due.
Only one Form 2820 will become due for any given patient.
The contact information provided in Form 2820 will allow CIBMTR to contact recipients for the purpose of inviting them to participate in patient reported outcomes (PRO) data collection for the CIBMTR Research Database or other BMT CTN or RCI BMT research studies. To maintain privacy and keep contact information protected, the data provided in Form 2820 is stored in a separate area of the CIBMTR database. Access to these data is highly restricted and governed by CIBMTR policy.
Links to Sections of the Form:
Q1-5: Indication
Q6-21: Recipient Contact Information
Q22-38: Parent / Legal Guardian Contact Information
Q39-58: Alternate Contact Information
Manual Updates
The most recent updates to the manual can be found below. Please note, the below updates were to the Forms Instruction Manual. All updates to the 2804 will now be documented in FormsNet3 Instructions.
If you need to reference the historical Manual Change History for this form, please reference the retired manual section on the Retired Forms Manuals webpage.
| Date | Manual Section | Add/Remove/Modify | Description |
|---|---|---|---|
| 1/21/2021 | 2820: Recipient Contact Information | Modify | Instruction text updated: This question should be answered ‘yes’ if the recipient has given permission to be directly contacted by CIBMTR for research as indicated on the |
| 8/2/18 | 2820: Recipient Contact Information | Modify | Version 2 of the 2820: Recipient Contact Information section of the Forms Instructions Manual released. Version 2 corresponds to revision 2 of the Form 2820. |