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Paul Strickland PET-CT Response Form

This form is for use by Paul Strickland Scanner Centre to submit the results of the 2nd reading.

Procedure to be Used Upon Receipt of PET-CT Scans - SOP to be used by the Paul Strickland Scanner Centre when receiving scans to be read from other centres

Response in Primary Tumour
Response in Nodes
Distant Metastases Detected (required)
If ‘Yes’, Indicate Type
Is there concordance between readings of Core Lab and Local Report? (required)
If ‘No’, Which report has been 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 as such is committed to protecting your data and rights in line with applicable data protection law (including the UK GDPR and the Data Protection Act 2018). Please review the privacy information (including privacy notices) provided by the University via the following link, for further information on your rights and how the University processes your personal data: Data Protection.

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