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National Prion Clinic

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Blood sample consent forms

At the National Prion Clinic we may ask our patients and research participants for consent to take a blood sample. These blood samples are used in studies investigating causes of and possible treatments for prion and other brain diseases, which may include genetic studies. Samples are used anonymously and any research results that are published do not identify the person who has provided a blood sample. Blood samples, with consent, can also be screened for abnormalities (mutations) that are associated with prion disease and related disorders. This routine diagnostic test may help to establish the precise cause of symptoms.


This form must be completed by individuals agreeing for their blood to be taken, for use in research investigating causes of and possible treatments for prion disease. All fields must be completed before samples can be processed.


This form must be completed by individuals agreeing for their blood to be screened for abnormalities (mutations) that are associated with prion disease and related disorders. All fields must be completed before samples can be processed.


This form should be completed by clinicians to request the vCJD blood based assay as described in Lancet 2011