Consortium Application

Please complete this application form if you would like to join the CIMBA Consortium. We will get in touch with you shortly regarding your application.

  • Please provide the full name of your study.
     
  • If your study has an acronym please provide this. This will be used most often when referring to your study.
  • Please provide a brief description of your study.
  • BRCA1/2 mutation carriers

    Please provide the current number of carriers with core phenotypic data available in your study who also have germline DNA samples and/or pathology/clinical follow up data. All 4 fields should be completed - please use numbers only and enter 0 if none. Use approximate number if exact number not known.
  • Contact details

  • Please provide the full name and title of the PI for the study.
  • Please provide a telephone number where you can be contacted.
  • Please provide an email address where consortium information can be sent.