AOSpine RECODE-DCM Study
Participant Registration Form
Principal Investigators: Mark R. Kotter and Benjamin M. Davies.
Which of these best describes your experience of DCM?
Country of residence
You have been randomized to answer questions on research priorities. There is an option to complete this survey anonymously. Please be aware, in order to be acknowledged on published material and invited to the consensus meeting, a name and email contact are required.
I would like to to be acknowledged as a contributor to RECODE-DCM on any published material:
After completing ALL rounds of the online survey, I would be interested in being contacted about attending the RECODE-DCM international face-to-face consensus meetings:
I confirm that I have read the Conflict of Interest Information Sheet and hereby declare any conflicts of interest I may hold (e.g. competing professional or financial interests, or any other factor that may influence my responses):
I confirm that I have read the Participant Information Sheet including details of the management of my personal data and risks/benefits. I have had the opportunity to consider the information and ask any questions I may have. I understand that my participation is voluntary and that I am free to withdraw at any time without giving any reason, without my medical care or legal rights being affected. I hereby consent to be a RECODE-DCM study participant:
For more information, please see our study website: www.recode-dcm.com
If you have any questions or concerns, please contact us via email: email@example.comIf you are upset or concerned following completion of the survey, support is available from our charity partner:www.myelopathy.org