How Do I Participate?
You may be asked to take part in The Medical College of Wisconsin Tissue Bank if you are being seen at Froedtert Hospital or The Medical College of Wisconsin for screening, evaluation, diagnosis or treatment. As a patient, you have the option to allow The Medical College of Wisconsin Tissue Bank to store your blood and tissue along with identifying information related to your specimens such as your name, date of birth, and gender.
Your specimens would be stored for possible use in future research studies. These studies may result in the discovery of medication, advancement of treatments, and even possible cures for diseases. There is no direct benefit to you other than the satisfaction of helping to advance knowledge. You will not be paid for your specimens nor receive any payment from patents or products that result from the research.
If you consent, there will be a one-time extra blood collection at your next routine blood draw. No extra needle sticks will be necessary and the amount of extra blood taken will be less than 1 tablespoon.
In the event that you have surgery, we would also be asking to store any leftover tissue from that surgery as well as any future surgeries that you may have here. The leftover tissue that we would receive is tissue not needed by your doctor for clinical reasons, such as a diagnosis, and is normally discarded.
No additional procedures will be done for the purpose of The Medical College of Wisconsin Tissue Bank. If you are signed up to participate in other clinical trial research, your donation to the Tissue bank will not negatively affect that research. Any donation to the Tissue Bank is collected after all other needs are met.
If you choose to participate, you can change your mind and withdraw, in writing, at any time. No matter what your decision is, it will not affect your health care. If you are interested, please speak with a clinic desk, or call 414-805-8829 to schedule a consent conference.
Need More Information?
The Medical College of Wisconsin
MCW Tissue Bank
8701 Watertown Plank Rd.
Milwaukee, WI 53226
Institutional Review Board
The Institutional Review Board (IRB) is a committee of doctors, researchers and members of the community who are responsible for protecting the rights, welfare and privacy of all individuals who participate in research sponsored by The Medical College of Wisconsin as well as Froedtert Hospital.
The IRB reviews all research studies involving human subjects to ensure safety, compliance with laws and regulations, scientific quality, and ethical standards. Specimens donated to the Tissue Bank cannot be used for research without the permission of the IRB.
Your Privacy is Important to Us
While we make every effort to keep your information confidential, it is possible that an unauthorized person might see it. To guard against this, information in the Tissue Bank is password-protected and access to the bank is limited to authorized personnel.
The Medical College of Wisconsin is required by law to protect your health information; however, the law does afford exceptions for certain agencies and persons to see and share your health information for research. These may include the sponsors of the research; the Food and Drug Administration; Department of Health and Human Services; and/or Data Safety Monitoring Boards.
The Medical College of Wisconsin only provides your health information to these groups when required by law or by approval from the Institutional Review Board.MCW Tissue Bank Consent Form – Sample