Childhood Overgrowth (COG) study Recruitment checklist (version 1 / June 2009) Patient Name……………………………………………………………………… Patient dob………………………………………………………………………… Your reference ID…………………………………………………………………. 1. Information sheet given to family 2. Completed questionnaire 3. Copies of clinic letters 4. Copies of molecular reports 5. Photographs 6. Pedigree if there is a relevant family history 7. Informed consent (enclose copy) 8. Samples 9-18ml blood (EDTA) / DNA sample from patient 9-18ml blood (EDTA) / DNA sample from mother 9-18ml blood (EDTA) / DNA sample from father Ideally 2x 9ml bottles, but we will include patients from whom less is available; please send samples from both parents if available, but we will include patients without parental samples. PLEASE SEND SAMPLES AND FORMS BY FIRST-CLASS POST TO: (PRE-PAID ADDRESS LABELS ARE AVAILABLE) Professor Nazneen Rahman Section of Cancer Genetics, Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey, SM2 5NG. Queries: Margaret Warren-Perry Tel. 020 8722 4377/4099 Fax. 020 8722 4359 Email grs@icr.ac.uk Please complete and return this form with the samples and clinical information