The purpose of the following page is to see if you meet the criteria for taking part in our research study on Neurofibromatosis Type 1. The page will include a series of questions (i.e. name, age, state of residence, and NF1 diagnosis) to verify that you are eligible for this study. 

The information you provide will be kept as confidential as possible as required by law.  It is possible that the Food and Drug Administration, and other federal and state authorities, may inspect this record.

The risk to filling out this screening form is minimal. It is not designed to ask you for sensitive personal information, but it is possible that some may feel uncomfortable answering these questions. If you qualify to take part in the study and are interested in taking part, then you may proceed to the study; this will be kept confidential, but there is a small risk that people outside of the research team could learn this information.  If you are not interested in the study, then your personal information will be destroyed.

If you have any questions, concerns, or complaints, contact our study researchers at (650) 725-3816.  If you want to talk to someone separate from the research team about a concern or complaint or your rights as a possible research subject, please contact the Stanford Institutional Review Board (IRB) to speak to an informed person who is separate from the research team, at 650-723-5244 (for medical studies), 650-723-2480 (for nonmedical studies), or toll-free at 1-866-680-2906.  

Please select “Yes” if you agree to the below statements or “No” if you do not agree.

• I am able and willing to consent
• I am able to read and understand the consent form
• I am able and willing to complete all study procedures
• I am willing to provide responses to the survey that will follow this page
• I am willing to upload photos of my neurofibromas skin lesions.