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Form for requesting DNA material

Third parties wishing to use material from the Euro-MRX consortium must accept the following agreement:

  1. If the gene(s) to be screened are known (e.g. from the NCBI list or from OMIM), the names of those gene(s) must be disclosed to the consortium, by completing the corresponding field on the request form. This information will only be received by the database manager, Dr. A.P.M. de brouwer, who will treat the data confidentially.
  2. Consortium material will not be sent to another party, and will only be used for the requested investigations
  3. The results of the investigations will be sent to the consortium database manager Dr. A.P.M. de Brouwer
  4. When a mutation is found, the cosegregation of the mutation and the MR in the family will be carried out by the consortium member in whose family the mutation was found. If this full member is for whatever reason not in a position to do so, the third party will do it
  5. In case of publication, co-authorship is provided to each full member. When applicable, the referring physician will be offered a co-authorship as well.

Request Form
The gene(s)/exon(s) you wish to screen: *
The group from which you want to request DNA: *

a  MRX families
b  linked families
c  unlinked families

Your name:
Your institute:
Your address:
Your telephone number:
Your email address:
Comments/remarks:
I agree to the terms stated above the request form

* Upon approval of your request, you will be sent DNA of families with linkage data overlapping the gene(s)/exon(s) you fill in. If instead you wish to request DNA of one particular family, please enter the code of the family of interest in the Comments/remarks field.