These will be completed by phone or in person with SUDCRRC. Once signed by you, you will return those hard copies to the SUDCRRC address on right. The SUDCRRC representative who obtained your consent, will sign those originals and email you a completed version in pdf by email.
Mail to Address:
NYU Comprehensive Epilepsy Center
223 East 34th St, Ground Floor
New York, NY 10016
This can be scheduled with email@example.com with the goal of completion within one month of study enrollment. Please allow an hour for this phone call.
Links to Interview will be emailed prior to call.
The SUDCRRC will need all of your child’s medical records. These include: prenatal records, hospital birth records, pediatric records, ER and hospitalizations records, specialists records and any medical tests they had performed during their life.
This can be time consuming and the review process cannot begin until all records have been obtained. Complete the MD list and email it to firstname.lastname@example.org. The Medical Record release form can be used to assist you in communicating with your providers. If you need assistance, please inform SUDCRRC.
SUDCRRC will send you a blood shipper kit after your enrollment. You can take this to your doctor for your blood draw, visit NYU for the blood draw or have the SUDCRRC schedule an in home appointment for you through a company we have contracted called EMSI. if you choose EMSI, they will contact you by phone and set up an appointment that is convenient for you.
Blood draws should only occur on Mon-Wed of non-holiday week. Email email@example.com in advance to communicate blood draw date.
SUDCRRC will work with them directly to obtain their investigative report and any specimens needed for the study. Complete the bottom portion of the MR release form to right and email to firstname.lastname@example.org.
SUDCRRC will obtain this from the Medical Examiner or Coroner, or other source based on discussions with you. If you have banked DNA from your child then we would ask you to complete a “withdraw” form in order for that sample to be sent to the SUDCRRC. If you are interested in DNA banking but have not done so, please see this webpage for more information.