Consent forms for SACT (Systemic Anti-Cancer Therapy)

Chemotherapy consent form image

What's new?

21 May 2018: Atezolizumab + Pembrolizumab for bladder cancer

21 May 2018: Atezolizumab for lung cancer


Are you a clinician or other healthcare professional involved with consenting and treating patients with Systemic Anti-Cancer Therapy (SACT)?

We are working with Guy’s and St. Thomas’ NHS Foundation Trust to produce national standardised SACT regimen-specific consent forms.

Endorsed by the National Chemotherapy Board, we want to support clinicians in ensuring all patients are fully informed when consenting to SACT.

The National Chemotherapy Board has also issued guidance for the introduction of the national SACT regimen-specific forms by individual chemotherapy providers.

The consent forms and guidance document are available to download in PDF format. Forms are grouped by tumour-site.

Which tumour site groups are forms available for?

The regimen-specific forms are being published in tumour site groups, on a rolling schedule. They will all be available by Autumn 2017. The order of roll-out is as follows:

  • Generic form
  • Breast cancer
  • Head and neck cancers
  • Gynaecological cancers
  • Melanoma
  • Lung cancer
  • Colorectal cancers
  • Immunotherapy generic form
  • Supportive therapies (denosumab, zoledronic acid)
  • Upper Gastrointestinal (GI) cancers
  • Chronic myeloid leukaemia (CML)
  • Chronic lymphocytic leukaemia (CLL)
  • Urological cancers
  • Brain and CNS cancers
  • Skin (non-melanoma) cancers
  • Thyroid cancer
  • Lymphoma
  • Multiple myeloma
  • Acute myeloid leukaemia (AML)
  • Myeloproliferative neoplasms (MPN)

Please check the website for new forms and updates.

What should I do if I cannot find the regimen-specific form I need?

We would encourage Trusts to use the generic form where a regimen-specific form does not exist.

What should I do if I am experiencing problems accessing the forms on the website?

If you can’t open the accordions or download the forms it’s usually because of the browser or the computer settings. If it’s the browser it’s often due to a corruption or long session so closing the browser and opening a new one and trying again should fix it. If not, try re-booting to clear the memory and trying again. If you’re still experiencing problems contact your IT team to check your settings aren’t preventing downloads. The forms are PDFs so you will need Adobe Acrobat to read them. If you don’t have this you should be prompted to download it when you try to open a form. Check with your IT team if you have problems viewing the downloaded forms.

How have the forms been developed and what is the governance process?

The forms are based on the Department of Health consent form 1. The template form has been approved by the National Chemotherapy Board. Each hospital/Trust will need to ensure that the forms are approved for use locally by their governance or consent committee, whichever is most appropriate for the individual organisation.

How do I give a copy of the completed form to the patient?

The patient can be given a photocopy of the completed form. We recommend retaining the original form in the patient’s records.

Is there a generic form for immunotherapy?

We plan to develop a generic form for immunotherapy, as we recognise that risks and side effects are different to those for conventional chemotherapy. This will be published on the website in the coming months. The generic form for immunotherapy can be used wherever a regimen-specific form for immunotherapy is not available.

Are there plans for the forms to be made available in Welsh?

We are liaising with NHS colleagues in Wales regards translation of the forms into the Welsh.

Where can I find more information about the regimen-specific consent forms?

Further information can be found on You can also email if you have queries and with any comments.

Download these FAQs

Last updated: 12th May 2017

Who has approved the content in these forms?

The programme is being led by a dedicated CRUK-funded oncology pharmacist at Guys’ and St. Thomas’ NHS Foundation Trust.

All forms are independently checked by an oncology/haematology pharmacist, oncology/haematology consultant and member of the National Chemotherapy Board.

Publishing, additions and updates

We are publishing forms by tumour site, the first were for breast cancer in May 2016. We will publish new forms for other tumour sites regularly.

Recent additions and updates will be highlighted on the "What's new?" section on this page, and details of when forms have been last updated is stated in each section. Please check for updated versions and ensure that you use the latest version of each form.

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