Thank you for reading the FastMRI DYAMOND Stage 2 information leaflet and for considering participation in this important research. If you would like to take part in Stage 2 of the FastMRI DYAMOND Study please complete the following consent form. If you have not received an Information Leaflet about the FastMRI DYAMOND Study (Stage 2), or if you would like to discuss it with a researcher, please contact your local research team on FASTMRI@nbt.nhs.uk or 0117 414 7014.

Important - Please do not try to consent until you have first spoken to a member of the consenting team who will contact you in advance.

I confirm that I have read the Information Leaflet about the FastMRI DYAMOND Study (Stage 2) version 3.0 (dated 18/01/2024). I have had the opportunity to consider the information and to ask questions and I have had these questions answered satisfactorily.

I understand that my participation is voluntary and that I am free to withdraw consent at any time without giving any reason, without my medical care or legal rights being affected.

I understand that relevant sections of my medical notes and data collected during the study, may be looked at by individuals from North Bristol NHS Trust (who sponsor the study), regulatory authorities, or the NHS Trust, where it is relevant to my taking part in this research. I give permission for these individuals to have access to my records.

I give permission for data collected about me, including images (MRI and mammogram) to be used to support further training for others and ethically approved research in the future. I understand that nobody will be able to identify me from these data.

I agree to my General Practitioner (GP) being informed of the results of my FAST MRI scan.

I understand that I may be invited for further clinical investigations which may include x-rays and understand the risks associated with this. These have been outlined in the Participant Information Sheet.

I understand that information held by the NHS, including by the Breast Screening Programme and the Cancer Registry may be used to provide information about my health status and I give permission for long term anonymised storage and use of this and other information about me, for health-related research purposes only (even after my incapacity or death).

I agree to complete a short survey about my experience of having a FAST MRI scan and understand that I may also be contacted by telephone for a short interview about this (and that there will be an opportunity for me to opt out of the telephone interview within the survey).

(Optional)