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Type 1 Diabetes TrialNet at Vanderbilt

Remote Risk Screening for Type 1 Diabetes
 
Do you have type 1 diabetes in your family?  If the answer if YES, screening for the risk of developing Type 1 diabetes can happen at numerous locations across the nation.
 
To arrange for a lab kit to be sent to your family member, please review participant requirements.
 
To participate in the Natural History Study, you must be:
            ·  1 to 45 years of age and have a brother, sister, child or parent with type 1 diabetes
                                                   OR
            ·  1 to 20 years of age and have a cousin, aunt, uncle, niece, nephew, half-sibling or grandparent with type 1 diabetes
 
Then, call 615-936-TNET or 888-VU4-TNET or email diabetesresearch@vanderbilt.edu to arrange phone consent and assent for participation. Print one Screening Form and one Family History Form for each person volunteering (see below). Print the Adult Consent form for volunteers 18 and over. Print the Parent Consent for parents and legally authorized representatives to give permission for their child to participate. Children also need to give their assent on the appropriate form below.   After giving phone consent and completing the paperwork, please fax the consents and assents along with one screening form and one family history form per volunteer to our secure fax line (615-936-7001).  At that time we will mail you a lab kit to the address listed on the Screening Form.
 
You can take the lab kit to a lab or medical professional in your area to draw the tube of blood.
 
Then you will overnight the lab kit back to us in a FedEx pak that we provide you.
 
Lab and shipping costs are covered by our research grant.
 
 
Click here for the Screening Form - Please do not include social security number.
 
Click below for the consent and assent forms:
Adult Consent Form - volunteers 18 and over
Parent Consent Form - parents to allow their child to participate
Teen Assent Form  - teens 13 to 17
Child Assent Form  - children 7 to 12

This page was last updated May 20, 2013 and is maintained by