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QT Registry Submission Kit

Should you find it necessary to collect samples without waiting for our mailed submission packet, the instructions and forms below will guide you through the process.

Preview and download the appropriate form from the list below (requires Adobe Acrobat Reader). Please if you have questions or need further information.

 
Consent Forms (PDF)

 » English: Adult | Parent/Gurdian
 » Spanish: Adult | Parent/Guardian

 » Collection and Shipping of Samples
 » Registration Submission Form

 

 
 

Arizona Center for Education and Research on Therapeutics
The Critical Path Institute

Tucson, Arizona and Rockville, Maryland

Funded in part by Agency for Healthcare Research and Quality grant 1 U18 HS10385-01

Disclaimer and Waiver
The information presented is intended solely for the purpose of providing general information about health related matters. It is not intended for any other purpose, including, but not limited to, medical or pharmaceutical advice and/or treatment, nor is it intended to substitute for the users' relationships with their own health care/pharmaceutical providers. To that extent, by continued use of this program, the user affirms the understanding of the purpose and releases The Critical Path Institute, The University of Arizona, State of Arizona and Arizona Board of Regents from any claims arising out of his/her use of the website.

Information Center For Consumers For Professionals