CONSENT TO SCREEN AND FOLLOW-UP
i. I consent to undergo colorectal screening under the Faecal Immunochemical Test (FIT) screening programme (the “Programme") managed by Singapore Cancer Society (SCS) and Health Promotion Board (HPB).
ii. I will follow the instructions on the FIT kit. I understand that my samples will be sent to the appointed Service Providers' for testing.
iii. I understand that FIT may not always find or rule out the presence of colorectal cancer. I should see a doctor if I feel unwell or have any symptoms, even if my FIT result is normal or I have any clarifications on my results.
iv. I understand that I will be notified of my test results by post and that I will be invited to attend re-screening at the recommended times. Depending on my FIT results, I may be contacted and/or referred by SCS, HPB or Service Providers for post-screening follow-up.
COLLECTION AND USE OF INFORMATION
I acknowledge that my personal data, relevant screening and follow-up information, including the FIT results (collectively, the “Information2”) will be collected, disclosed and used by SCS, HPB or Service Providers for the purposes of, conducting the tests, and managing and implementing follow-up action arising from the test results. I also acknowledge and consent that the Information and my past screening and follow-up Information will be retained by SCS, HPB, the National Electronic Health Records (NEHR) and MOH and that aggregate/de-identified Information may be used for research, statistical and planning purposes.
I agree and allow SCS, HPB and Service Providers to approach HPB's Collaborators, which are in the possession of my Information to request for such records (if any) for the purposes of patient care, treatment or clinical / programme review.
DISCLOSURE OF INFORMATION
I consent to the collection, use and/or disclosure of my Information and past screening and follow-up history under all of HPB Screening Programmes to HPB's Collaborators3 (where necessary), for the purpose of checking if I require re-screening, further tests, follow-up action and/or referral to community programmes/activities.
I do not consent to SCS and HPB disclosing the Information and my past screening and follow-up information to HPB's collaborators for the purposes mentioned in Para 4.
I consent to allow Singapore Cancer Society (“SCS”) to collect, use, disclose and/or process my personal data in order to process, administer, facilitate, maintain and/or manage my relationship with SCS as a member, volunteer, programme participant, beneficiary and/or donor (“Purpose”), including communications on SCS’ activities, programs and services; donation requests; carrying out research, analysis and development activities for SCS’ purposes; and making disclosures required by law or a competent authority. SCS may, for the above Purpose, disclose my personal data to its third party service providers and/or agents, who may be sited outside of Singapore (subject always to requirements under applicable law having been met).
1 Service Providers refer to SCS and HPB appointed healthcare institutions/cIinics/service providers participating in the Programme.
2 Information refers to participant’s past screening and follow-up information under all of HPB’s screening programmes.
3 Collaborators refer to organisations/ institutions in partnership with HPB for the provision of screening and follow-up related services.