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SCNIR

Severe Chronic Neutropenia International Registry

  • General
    • Neutropenia
      • Congenital Neutropenia
      • Cyclic Neutropenia
      • Idiopathic Neutropenia
      • Autoimmune Neutropenia
    • Patient Handbook
    • Genetic Patterns
      • Autosomal Inheritance
      • X-linked Recessive Inheritance
    • SCNIR Advisory Board
    • Partners
    • Cyclic Neutropenia Tool – Lomb’s Periodogram
  • For Patients and Families
    • How to Enroll
    • Frequently Asked Questions
      • KnippeRx
      • Neutropenia Health Tips
      • Sports Kit
      • School Kit
      • Best Choice of Syringes for You
        • Administering 3 to 90 micrograms
        • Administering 90 to 150 micrograms
        • Administering 150 to 300 micrograms
      • G-CSF Dosing for Specific Neutropenia
        • Congenital Dosing Guidelines
        • Cyclic Dosing Guidelines
        • Idiopathic Autoimmune Dosing Guidelines
        • Cohen Dosing Guidelines
        • Barth Dosing Guidelines
      • Working With Health Professionals
      • How Neupogen Helps Maintain Your Neutrophil Count
      • Calculating an Absolute Neutrophil Count
    • Glossary of Terms
    • Helpful Links
  • For Physicians
    • How to Enroll Your Patient
    • Genetic Causes of Neutropenia
      • ELANE Analysis Published through SCN Registry
      • ELANE Analysis Published in Other Literature
      • Genetic Mutations
  • For Researchers
    • SCNIR Data Request Form
    • SCNIR Bio Sample Request Form
  • Forms
    • Registry Forms
      • Registry Protocol
      • Registry Screening Checklist
      • Registry Consent Forms
      • Registry HIPAA Form
      • Registry Registration Form
      • Registry Permission to Discuss Health Information Form
      • Registry Yearly Forms
      • Registry Specialty Forms
      • Registry Renewal Form
    • Repository Forms
      • Repository Protocol
      • Repository Consent Forms
      • Repository HIPAA Form
      • Repository Renewal Form
    • dbGaP Consent Form
  • Bibliography
    • Main Bibliography
    • Clinical Management Bibliography
      • Bone Density Bibliography
      • Hematopoietic Stem Cell Transplantation Bibliography
      • Pediatrics Bibliography
      • Pregnancy Bibliography
    • CRISPR Bibliography
    • Genetics Bibliography
      • Barth Syndrome Bibliography
      • CSF3R Bibliography
      • ELANE Bibliography
      • G6PC3 Bibliography
      • GSDIb Bibliography
      • Shwachman-Diamond Syndrome Bibliography
      • TCIRG1 Bibliography
      • Wiskott-Aldrich Syndrome Bibliography
      • WHIMs Bibliography
    • Malignancy Bibliography
    • Severe Chronic Neutropenia Bibliography

Repository Consent Forms

REPOSITORY NEUTROPENIC SUBJECT FORMS

Neutropenic Subject Consent Form

REPOSITORY FAMILY MEMBER SUBJECT FORMS

Family Member Subject Consent Form
Family Member Subject Assent Form
Family Member Subject Verbal Script Form
Family Member Subject HIPAA Form

NORMAL VOLUNTEER SUBJECT FORMS

Normal Volunteer Subject Consent Form
Normal Volunteer Subject HIPAA Form

Contact Us

North America Office

David C. Dale, MD*
Box 356422
1959 NE Pacific Street, Room BB544
Seattle, WA 98195

Phone: 206-543-7218
Fax: 206-685-8055

Research Coordinators:
Email: bolyard@uw.edu

*If you send us a package (US Post Office, UPS or Fedex) with documents please obtain the tracking number and email the team the tracking number.

Europe Office

Connie Zeidler, MD
Severe Chronic Neutropenia International Registry
Medizinische Hochschule Hannover
Kinderklinik
D-30623 Hannover, Germany

Phone: +49-511-557105*
Fax: +49-511-557106*
Email: SCNIR@mh-hannover.de
Website: http://www.severe-chronic-neutropenia.org

*The + preceding the country code represents
the local predial code for international calls.

 

Site Search

Coronavirus

For questions concerning the coronavirus disease (COVID-19) please ask your doctor or visit the CDC website

Partners

  • National Neutropenia Network (NNN)
  • Ella Jewell Foundation
  • Shwachman-Diamond Syndrome Foundation
  • Cohen Syndrome Association
  • Barth Syndrome Association
  • Neutropenia Support, Australia & New Zealand
  • General
    • Neutropenia
      • Congenital Neutropenia
      • Cyclic Neutropenia
      • Idiopathic Neutropenia
      • Autoimmune Neutropenia
    • Patient Handbook
    • Genetic Patterns
      • Autosomal Inheritance
      • X-linked Recessive Inheritance
    • SCNIR Advisory Board
    • Partners
    • Cyclic Neutropenia Tool – Lomb’s Periodogram
  • For Patients and Families
    • How to Enroll
    • Frequently Asked Questions
      • KnippeRx
      • Neutropenia Health Tips
      • Sports Kit
      • School Kit
      • Best Choice of Syringes for You
        • Administering 3 to 90 micrograms
        • Administering 90 to 150 micrograms
        • Administering 150 to 300 micrograms
      • G-CSF Dosing for Specific Neutropenia
        • Congenital Dosing Guidelines
        • Cyclic Dosing Guidelines
        • Idiopathic Autoimmune Dosing Guidelines
        • Cohen Dosing Guidelines
        • Barth Dosing Guidelines
      • Working With Health Professionals
      • How Neupogen Helps Maintain Your Neutrophil Count
      • Calculating an Absolute Neutrophil Count
    • Glossary of Terms
    • Helpful Links
  • For Physicians
    • How to Enroll Your Patient
    • Genetic Causes of Neutropenia
      • ELANE Analysis Published through SCN Registry
      • ELANE Analysis Published in Other Literature
      • Genetic Mutations
  • For Researchers
    • SCNIR Data Request Form
    • SCNIR Bio Sample Request Form
  • Forms
    • Registry Forms
      • Registry Protocol
      • Registry Screening Checklist
      • Registry Consent Forms
      • Registry HIPAA Form
      • Registry Registration Form
      • Registry Permission to Discuss Health Information Form
      • Registry Yearly Forms
      • Registry Specialty Forms
      • Registry Renewal Form
    • Repository Forms
      • Repository Protocol
      • Repository Consent Forms
      • Repository HIPAA Form
      • Repository Renewal Form
    • dbGaP Consent Form
  • Bibliography
    • Main Bibliography
    • Clinical Management Bibliography
      • Bone Density Bibliography
      • Hematopoietic Stem Cell Transplantation Bibliography
      • Pediatrics Bibliography
      • Pregnancy Bibliography
    • CRISPR Bibliography
    • Genetics Bibliography
      • Barth Syndrome Bibliography
      • CSF3R Bibliography
      • ELANE Bibliography
      • G6PC3 Bibliography
      • GSDIb Bibliography
      • Shwachman-Diamond Syndrome Bibliography
      • TCIRG1 Bibliography
      • Wiskott-Aldrich Syndrome Bibliography
      • WHIMs Bibliography
    • Malignancy Bibliography
    • Severe Chronic Neutropenia Bibliography
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