Register

Register to the Queensland Cerebral Palsy Register (QCPR).

Registering your details to the Queensland Cerebral Palsy Register will help guide research projects into causes, prevention, treatment and living with cerebral palsy services.

Consent for Inclusion on the Queensland Cerebral Palsy Register

Important!
Before commencing registration, please complete the below QCPR Consent Form.

I have read and understood the Information Sheet and had any questions answered to my satisfaction. I understand that an individual may not directly benefit from membership of the CP Register and that no payment will be made for joining the register. I am aware that I should retain a copy of the consent form, when completed, and the information sheet for my records.

Your Name

Name of Person with CP

Date of Birth of the Person with CP

Your Relationship to the Person with CP

Your Email

Your Phone Number

I consent to the collection, recording and permanent storage of information relating to me / my child / the person, on the CP Register. This may involve consulting birth and medical records.

I consent to de-identified information being transferred to the Australian Cerebral Palsy Register.

I consent to receiving invitations from time to time from CP Register staff in relation to research studies.

I consent to health professional/s nominated by me / my child / the person responsible, being contacted if needed to assist in completing and / or verifying the details on the register. Only health professionals listed on the registration from will be contacted.

Once you have submitted the consent form, please complete the below form to register to the QCPR.

You do not need to complete all fields.

If you are unable to complete the full form, please leave your contact details below and our team will be in touch to support you through the registration process.

Download the registration form

Download the registration form here and email to direct to our research team at cpregister@cpl.org.au

Write to us

Write to us at Queensland Cerebral Palsy Register, PO Box 386, Fortitude Valley QLD 4006 Attention: Research team.

What next?

After completion of registration, our team will enter the details in the Australian Cerebral Palsy Register (if consent has been granted).

We respect your privacy and your information will not be shared with any organisation outside of the Australian Cerebral Palsy Register, this includes services providers and other cerebral palsy organisations.

If you give consent, you may receive notice about research that you are eligible to participate in. These notices will come directly from QCPR. Even if you give consent to receive information about research, your personal details will not be given to a researcher.

Register

Consent for Inclusion on the Queensland Cerebral Palsy Register

Once you have submitted the consent form, please complete the below form to register to the QCPR.

Other ways to register

Registration for Person with Cerebral Palsy

What next?

Have further questions?