LiFT UP Study

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4icpgfAAeUUjRTg5A7ikkGGukmsgYDgKwYcphFTJgTJJZXe6rPPN7tIxvuQXZXWbtS8x9ufLI

IRB #: 96144*/13325**
Project Title: Li-Fraumeni & TP53: Understanding & Progress (LiFT UP)
Principal Investigators: Dr. Judy Garber (Dana-Farber Cancer Institute), Dr. Stephen Gruber (City of Hope),& Dr. Christopher Amos (Baylor College of Medicine)

Thank you for your interest in LiFT UP. The purpose of this study is to learn how to better predict cancer risk for individuals with Li-Fraumeni syndrome and improve cancer prevention and treatment strategies for individuals with TP53 gene mutations.

Participation includes:

Consenting to join a research study
Allowing us to access your medical records
Providing a blood sample (and possibly, a blood draw may be done once a year)
Providing a saliva sample (and possibly, a saliva sample may be done once a year)
Allowing researchers to obtain stored tissue specimens from biopsies or surgeries
Completing short questionnaires periodically
We may ask you to consider inviting family members to enroll

Please click "Submit" if you want us to contact you to discuss this study.

*Molecular Genetic Studies in Cancer Patients and Their Relatives
**Hereditary and Other Risk Factors for Cancer (Project SEARCH)

Today's Date:

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M-D-Y

First Name:

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Last Name:

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Date of Birth

M-D-Y

Zip Code:

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Email:

Primary Phone Number:

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How did you hear about this research study? Please select all that apply.

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My Healthcare Provider

My Relative(s)

A Laboratory (genetic test report)

Li-Fraumeni Syndrome Association (LFSA)

Living LFS

Other

Please tell us the name of your healthcare provider who referred you to this study and the hospital or institution that they work at:

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Please list your relatives(s) who referred you, and their relation to you:

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Please tell us which laboratory referred you (or the laboratory indicated on your genetic test report):

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Please tell us which other laboratory referred you (or the laboratory indicated on your genetic test report):

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Please list who referred you or how you were referred to this study:

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Have any of your family members enrolled in this study already?

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Yes

I Don't Know

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Please list your relatives(s) who are enrolled in this study and their relation to you:

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Please select the ways that you would prefer to be contacted?

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Phone Call

Text Message

Please share your preferred language

Lead Site

COH

DFCI

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Participant Point Person

Aleck Cervantes

Rosa Mejia

Kevin Tsang

Samantha Stokes

Alison Schwartz

Sophie Hyman

Bita Nehoray

Joann Yuan

Gubidxa Gutierrez Seymour

Kaitlyn Lew

Lorena Reynaga

Kevin Short

Hadley Barr

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Survey entered manually by study team member?

Yes

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Enrollment Status

In progress

Complete/Consented

Decline

No Response, Could Not Consent

Consented

Ineligible

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Recruitment Notes

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Recruitment Tracking Checklist

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