AMR Self Notification
If you have recently been diagnosed with mesothelioma, please notify the AMR by completing the online form below.
If you choose to participate in the registry you will receive an information pack containing:
- Information sheet
- Consent form
Participation involves completing a questionnaire and taking part in a short telephone interview about your:
- Occupational and residential history;
- Family mesothelioma history (if any).
The information you supply will help to improve understanding about mesothelioma and asbestos exposure. Participation is voluntary and you can withdraw at any time by contacting the AMR. When completing the Questionnaire, don’t worry if you can’t remember something about your history. Any information that you provide is valuable. The purpose of the Questionnaire is to help identify when you have come into contact with asbestos during your life. Once the questionnaire is completed and returned you will be asked to take part in a short telephone interview involving more detailed questions about your potential asbestos exposure.
Fields marked with an * are mandatory.