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Urology Volunteer Research Registry
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Thank you for your interest in enrolling in The University of Iowa’s Department of Urology registry for future research participants. The purpose of this registry is to identify individuals who have an interest in research studies conducted by researchers in the Department of Urology.

When a study is planned that appears to be appropriate for you based on the information you provide, you will be contacted by the Urology research recruiter by letter or email. The purposes of the contact will be to explain the study and to see if you are interested and eligible to participate. The number and type of study volunteers needed each year varies, so we can not guarantee that you will be contacted or enrolled in a study.

Participation in any study is voluntary. Submitting your name to the registry does not obligate you to respond to any requests for study volunteers.

If you would like to enroll, please read the following Consent Summary

Consent Summary: Volunteer Research Registry

If you agree to participate in the Registry, we will ask you to provide information about yourself including your birth date, gender, race and contact information. We will also ask you to provide information pertaining to your bladder health, in order to determine which research studies you may be eligible for. If you click the “Yes” box below, complete the information form on the next page, and submit the form, you become part of our Registry.

We will keep information you provide confidential. However, federal government regulatory agencies, auditing departments of the University of Iowa, and the University of Iowa Institutional Review Board (a committee that reviews and approves research studies) may inspect and copy records pertaining to this research.

Only University of Iowa Urology research staff have access to the Registry. Registry information is kept in a password-protected database. The information you provide for us will only be used for the purpose of contacting you for a possible future research study. Your contact information will not be sold or distributed to any outside party or institution.

There is no compensation for enrolling in this Registry and there are no costs for enrollment. There are no known risks from being in this Registry. However, we hope that others may benefit in the future from studies that may be conducted. Taking part in this Registry is completely voluntary. If you decide not to be in this registry, or if you stop participating in a study at any time, you will not be penalized or lose any benefits for which you otherwise qualify. If you do not wish to submit your information, close the web browser window without submitting the form.

If you have any questions about the Registry itself, contact Dr. Elizabeth Takacs at 319-384-5993, Diane Meyerholz at 319-356-1111 or Mary Eno at 319-384-9265. If you experience a research-related injury related to the registry, please contact: contact Dr. Elizabeth Takacs at 319-384-5993 or 319-356-1626 (24 hour page 1763). If you have questions about the right of research subjects or research related injury, please contact the Human subjects Office, 105 Hardin Library for the Health Sciences, 600 Newton Road, The University of Iowa, Iowa City, IA 52242, 319-335-6564, or e-mail irb@uiowa.edu.

If at any time you would like to remove your name from this participant database please call Diane at 319-356-1111 or Mary at 319-384-9265. You may print this page for your records.

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