Myriad Collaborative Research Registry

Welcome

Thank you for your interest in helping to advance science by participating in a registry through Myriad Genetics, Inc. (MGI). In this registry, de-identified information will be shared about people like you who have had genetic testing. The main purpose of this registry is to create a resource to enable researchers to see how genetic and genome information relates to cancer treatment and management.

Please read the information below to learn about what your participation in the registry would entail. If you would like to participate, please complete the consent below.

Consent to take part in the Myriad Collaborative Research Registry and authorization to use and disclose health information for research

Please read the information below to learn about what your participation would entail prior to signing the consent form. You must be 18 years of age (19 in Nebraska) to consent and participate in this registry. Please refer to our Privacy Policy for more information.

Precise Registry - Patient Consent







Type your name to provide an e-signature.

When you sign this form, you are agreeing for MGI, its subsidiaries, and third parties to retain your residual genetics sample and all data as described in this consent form. You are also agreeing to let MGI use and share the health information collected as part of this research as explained above. This means that you have read this consent form and you have decided to volunteer. A copy of this form will be available to you for your records. Please note, you need to take additional action via email to finalize your enrollment. After submission, please check your email to complete a final confirmation. Additionally, by signing this form, you acknowledge the following statements about the use of data and residual samples in future research studies:

  • De-identified information that may be used will not require re-contact for future research.
  • Identifiable information that may be used will require re-contact for future research, and you agree for MGI (or other researchers) to contact you.
Hidden Fields









By submitting your personal information, you agree to be contacted with newsletters, marketing or promotional materials, and other information that may be of interest to you. You may opt-out of receiving communications from us by following the unsubscribe link or the instructions provided in the communication we send. For further information on our privacy practices and commitment to protecting your privacy, please visit our Privacy Notice.