Patient Registry
Since pilomyxoid astrocytoma is such a rare tumor, we have begun assembling a registry of patients to facilitate research into this disease. Research into pilomyxoid astrocytomas requires clinical information. It is only with this information that we will be able to carry out meaningful research and advance our knowledge of this disease.
Patients interested in contributing towards our cause need only download and complete the following forms. Once we have received these forms you will be contacted by Dr. Komotar so that we may verify receipt of the forms, answer any questions you have regarding the study, and obtain oral consent to contact the treating physician. Following this you will be enrolled in the registry, and your active paticipation will be complete. This process should take no longer than 10 minutes. We thank you in advance for your time and effort in helping us fight this disease.
To join our registry, please download and complete the following three/four forms. (Adobe Acrobat is required to view these files. You can download this program at Adobe Acrobat):
Consent Form and Assent Form (children 8-15yrs)
Please mail or fax to:
Ricardo J. Komotar, M.D.; Columbia University College of Physicians and Surgeons; 630 West 168th Street; Room 5-462; New York, NY 10032; Fax: 212-305-5544
Please send all faxes ATTN: Dr. Ricardo Komotar.
Protocol Approval #: IRB-AAAA8505