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Bristol CT/MRI Reporting Form 2: Response to CRT

This form is to be filled in by the Bristol Medical Centre after the reading of the CT/MRI scans

Procedure to be Used Upon Receipt of CT-MRI Scans - SOP to be used by the Bristol Royal Infirmary centre when receiving scans to be read from other centres

Scan Type (required)
Response in Primary Tumour (required)
Response in Nodes (required)
Distant Metastases Detected (required)
If ‘Yes’, Indicate Type
Is there concordance between readings of Core Lab and Local Report? (required)
If ‘No’, Indicate here which report was accepted
Privacy notice
The information provided will be used solely for the PET-Neck Trial

The University of Warwick is the Data Controller of any information you have entered on this form and is committed to protecting the rights of individuals in line with Data Protection Legislation. The University's Data Protection webpages provide further information on your rights and how the University processes personal data. If you wish to submit a data subjects rights request, make a complaint or report a suspected personal data breach, please contact the University’s Data Protection Officer by email at infocompliance@warwick.ac.uk.

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