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CONSENT FORM
HIPAA Compliant
Institutional Review Board for Baylor College of Medicine and Affiliated Hospitals
SCALPH33692 SCALP COOLING FOR ALOPECIA PREVENTION (SCALP)
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Who needs h-33692- scalp cooling for?
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h-33692- scalp cooling can be beneficial for individuals:
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- undergoing chemotherapy treatment for cancer
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- who are at risk of hair loss as a side effect of the treatment
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- who wish to prevent or minimize hair loss during chemotherapy
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- seeking to maintain a sense of normalcy and improve self-esteem during treatment
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What is h-33692- scalp cooling for?
h-33692- scalp cooling is used to prevent or reduce hair loss during chemotherapy treatment.
Who is required to file h-33692- scalp cooling for?
Patients undergoing chemotherapy treatment and interested in using scalp cooling may need to file h-33692- scalp cooling forms.
How to fill out h-33692- scalp cooling for?
To fill out h-33692- scalp cooling forms, patients need to provide their personal information, medical history, and preferences for using scalp cooling during chemotherapy treatment.
What is the purpose of h-33692- scalp cooling for?
The purpose of h-33692- scalp cooling is to minimize hair loss in patients undergoing chemotherapy, thus helping to maintain their self-esteem and confidence.
What information must be reported on h-33692- scalp cooling for?
Patients need to report their contact information, medical history, chemotherapy treatment details, and preferences for using scalp cooling.
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