We want to support clinicians in ensuring all patients are fully informed when consenting to SACT. These forms are endorsed by the UK Systemic Anti-Cancer Therapy Board (UK SACT Board).
The programme is being led by a dedicated Cancer Research UK 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 UK SACT Board.
The consent forms and guidance document are available to download in PDF format. Forms are grouped by tumour-site.
If you have specific queries or are looking for something not covered here, please email the pharmacist.
alia.nizam1@nhs.netSACT consent forms are currently being reviewed on a rolling schedule. Please see FAQs for order of roll-out. Republication dates may exceed the date of review indicated on each form. All forms are valid until new versions are available.
21 October 2025: Durvalumab with Carboplatin and Paclitaxel (+/- Olaparib) added for Gynaecological cancers
21 October 2025: Durvalumab with Tremelimumab consent form added for HPB cancers
21 October 2025: Fruquintinib consent form added for colorectal cancer
21 October 2025: Sacituzumab Govitecan consent form updated to include a statement for growth factors
8 September 2025: Supportive medicines - reviewed and updated
For more information about our review plan schedule please see our frequently asked questions.
The regimen-specific forms have been published for the following tumour site groups. Each group of forms will be reviewed on a rolling schedule every three years. The process by which each group of forms is revalidated may result in the republication dates exceeding the date of review indicated on each group of forms. All forms are valid until new versions are made available.
Tumour site | Issue date | Review date |
|---|---|---|
Advanced Systemic Mastocytosis (AdvSM) | Jun-25 | Jun-28 |
Acute Lymphoblastic Leukaemia (ALL) | Mar-24 | Mar-27 |
Acute Myeloid Leukaemia | Mar-25 | Mar-28 |
Brain & CNS | Apr-23 | Apr-26 |
Breast | Jun-25 | Jun-28 |
Children & Young Person ALL | Aug-23 | Aug-26 |
Children & Young Person Generic | Sep-22 | Sep-25 |
Chronic Lymphocytic Leukaemia (CLL) | Nov-23 | Nov-26 |
Chronic Myeloid Leukaemia (CML) | Jul-23 | Jul-26 |
Colorectal | Jun-22 | Jun-25 |
Gastrointestinal Stromal Tumour (GIST) | Jul-23 | Jul-26 |
Generic English SACT & Immunotherapy | Nov-23 | Nov-26 |
Generic Welsh SACT & Immunotherapy | Nov-23 | Nov-26 |
Gynaecological | Nov-24 | Nov-27 |
Head & Neck | Aug-22 | Aug-25 |
Hepatobiliary | Sept-24 | Sept-27 |
Kaposi Sarcoma | Jul-23 | Jul-26 |
Lung | Oct-22 | Oct-25 |
Lymphoma | In development | |
Multiple Myeloma (phase 1) | Sept-24 | Sept-27 |
Multiple Myeloma (phase 2) | In development | |
Myeloproliferative Neoplasms (MPN) | Oct-24 | Oct-27 |
Neuroendocrine & Adrenal | May-24 | May-27 |
Oesophagogastric | May-25 | May-28 |
Sarcoma | Mar-24 | Mar-27 |
Skin – Melanoma | Mar-25 | Mar-28 |
Skin – Non-Melanoma | Feb-24 | Feb-27 |
Supportive Medicines | Aug-25 | Aug-28 |
Thyroid | Aug-25 | Aug-28 |
Urology – Bladder | Jan-25 | Jan-28 |
Urology – Germ Cell | Jun-24 | Jun-27 |
Urology – Prostate | Aug-22 | Aug-25 |
Urology – Renal Cell Carcinoma | Aug-22 | Aug-25 |
Urology – Small Cell | Aug-22 | Aug-25 |
Please check the website regularly (e.g. once a month) for new forms and updates.
We are working to develop and publish consent forms in time with publication of positive NICE (England), AWMSG (Wales), SMC (Scotland) and HSCNI (Northern Ireland) determinations.
We encourage Trusts to use the generic SACT or immunotherapy forms where a regimen-specific form is not available. Please get in touch with the project lead pharmacist so that this can be discussed with the tumour-specific lead consultant for development. Contact details for the project lead pharmacist are found at the end of this document.
CML, CLL, MPN, AML, ALL and multiple myeloma consent forms have now been published. Lymphoma consent forms are in development.
The forms are based on the Department of Health consent form 1. The template form has been approved by the UK Systemic Anti-Cancer Therapy 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. Please refer to the Guidance on Consent for SACT available(PDF, 3.83 MB).
The consent form is not a legal document, but it represents best practice and conforms with and complements the guidance documents available to clinicians taking consent. Several guidance documents have described best practice in the area of consent with respect to law, ethics, training and experience required and the need for documentation that consent has taken place.
We explored informal counsel with a medico-legal advisor, in response to the issue of the Montgomery judgement. The following has been taken from their reply:
“The issue of Montgomery is much misunderstood I think in terms of what it means for individual clinicians. It does have a bearing on the legal position if a claim is made, but the standard to which individual doctor must adhere with regard to the consent process is the GMC guidance. The Montgomery judgement really only brings the legal situation in the claims process into line with what doctors have been obliged to do since this GMC guidance was issued in 2008.
The most important aspect of the GMC guidance is that information about risk must be individualised for that patient. So for example, risk of cardiac events may be higher in a patient with pre-existing cardiac disease, or peripheral neuropathy may be more relevant if you are a concert pianist, as opposed to a patient who is not. These are probably the most comprehensive and patient friendly consent forms I have seen.”
The consent forms are developed to ensure a high level of consistency in the information giving and discussion with the patient. Your Trust Governance and/or consent committee must agree before you use these forms.
The patient can be given a photocopy or print out of the completed form. For trusts using electronic consent systems, there may be different mechanisms for providing the patient with a completed form depending on the system used, such as through secure email or a mobile application. We recommend retaining the original form in the patient’s records, or a scanned copy in the patient’s electronic records.
Due to the complexity of the IT infrastructure, numerous electronic patient records and SACT prescription systems across the NHS, the project team cannot provide one single national electronic consent solution.
An electronic consent working group was subsequently formed as part of the project. The working group developed and published the ‘Guidance for the Implementation of CRUK SACT Consent Forms Electronically’. It is intended for use by NHS SACT providers wishing introduce electronic consent to decide which electronic consent solution would be the most appropriate for their individual needs. Guidance for the configuration and maintenance of electronic consent forms, including adoption of the CRUK consent forms electronically, is provided in this document(PDF, 2.55 MB).
The CRUK regimen-specific consent forms may be used within local electronic consent systems. As the forms have been through a robust governance process to ensure their consistency and quality, the following disclaimers should be used depending on the applicable scenario. The following disclaimers will be included in the next version of the Guidance on Electronic Consent along with CRUK brand guidelines for logo use.
The CRUK logo and consent form footer can be included in electronic consent forms where the content of the forms is used unamended in its entirety. The format, font or colours can be changed if necessary, but the text and CRUK logo should be unamended. The footer at the bottom of each page of the consent form includes the names of those who have prepared, checked and approved the forms, as well as the details of version and date.
In this instance, please include the following disclaimer:
The content of this form was developed by Cancer Research UK and Guy’s and St Thomas’ NHS Foundation Trust. Cancer Research UK and Guy’s and St Thomas’ NHS Foundation Trust will not accept any responsibility for any claim whether for damages or otherwise, or any other liability arising out of or in connection with the form or its use.
Where providers base their electronic consent forms on the CRUK consent forms but change some of the content for technical or clinical reasons, the CRUK logo and consent form footer should not be used.
The following disclaimer should be included within the e-consent system in a way that makes it clearly visible to both clinician and patient.
Parts of this form are based on content developed by Cancer Research UK and Guy’s and St. Thomas’ NHS Foundation Trust. Some of that content may have been selected and/or modified by the electronic system provider, hospital trust or clinician depending on the patient’s individual circumstances. It is the responsibility of each individual organisation to ensure that relevant legal requirements and appropriate governance and safety clearance procedures within their own clinical services have been followed prior to implementation of electronic consent. Cancer Research UK and Guy’s and St. Thomas’ NHS Foundation Trust will not accept any responsibility for any claim whether for damages or otherwise, or any other liability arising out of or in connection with the form or its use.
The generic SACT and generic immunotherapy consent forms have been translated to Welsh. It is recommended that these forms are used to supplement the English regimen-specific consent forms when a Welsh language accompaniment is required. The project team continues to investigate avenues through which the translation of consent forms can be achieved.
These forms are designed specifically for taking consent for SACT. For instances where the SACT is given in combination with radiotherapy, the radiation therapy will need to be consented for separately. The Royal College of Radiologists (RCR) have developed national site-specific radiotherapy consent forms. These can be found here. The RCR plan to develop chemo-radiotherapy consent forms, but this is an ongoing piece of work for which timelines have not yet been confirmed.
The Children and Young People Generic Form was published in 2021. The ALL in Children and Young People form was subsequently published in 2023. We subsequently plan to develop national SACT regimen-specific consent forms for TYA groups.
Further information can be found in our FAQs and on this page. You can also email alia.nizam1@nhs.net if you have any queries and with any comments.
Download these FAQsLast updated: 19 August 2025
Guidance on consent for SACT(PDF, 3.83 MB)
Guidance on remote consent for SACT(PDF, 416 KB)
Guidance for SACT by Healthcare Improvement Scotland
Guidance on Electronic Consent for SACT(PDF, 2.55 MB)
Last updated: 18 June 2024
Generic SACT form(PDF, 117 KB)
Generic checkpoint inhibitor immunotherapy form(PDF, 132 KB)
Welsh Generic SACT form(PDF, 127 KB)
Welsh Generic Immunotherapy form(PDF, 136 KB)
Last updated: 9th October 2024
ALL in Children and Young People(PDF, 150 KB)
Children and Young people generic form(PDF, 195 KB)
Welsh ALL in Children and Young People(PDF, 307 KB)
Welsh Children and Young people generic form(PDF, 293 KB)
Last updated: 28th March 2025
Avapritinib(PDF, 116 KB)
Midostaurin(PDF, 116 KB)
Download all AdvSM SACT formsLast updated: 18 June 2025
Blinatumomab(PDF, 115 KB)
Clofarabine, Cyclophosphamide and Etoposide(PDF, 114 KB)
Imatinib(PDF, 127 KB)
Inotuzumab Ozogamicin(PDF, 115 KB)
Nelarabine, Cyclophosphamide and Etoposide(PDF, 120 KB)
Nelarabine(PDF, 120 KB)
Ponatinib(PDF, 128 KB)
Tecartus CAR T-cell therapy(PDF, 140 KB)
UKALL14 Consolidation 1,2 and 4(PDF, 125 KB)
UKALL14 Consolidation 3(PDF, 126 KB)
UKALL 14 Intensification CNS Prophylaxis(PDF, 122 KB)
UKALL 14 Maintenance(PDF, 132 KB)
UKALL 14 Phase 1 Induction(PDF, 125 KB)
UKALL 14 Phase 2 Induction(PDF, 125 KB)
UKALL 14 Intrathecal Systemic Anti-Cancer Therapy(PDF, 120 KB)
UKALL 60+ Intensive (Philadelphia Negative)(PDF, 121 KB)
UKALL 60+ Non-Intensive Intensive (Philadelphia Negative)(PDF, 133 KB)
UKALL 60+ Philadelphia Positive(PDF, 120 KB)
Download all ALL SACT formsLast updated: 16 May 2025
AIDA (All- transretinoic acid and Idarubicin)(PDF, 1.4 MB)
ATRA + ATO(PDF, 123 KB)
ATRA(PDF, 116 KB)
Azacitidine(PDF, 116 KB)
Azacitidine + Venetoclax(PDF, 116 KB)
DA (Daunorubicin and Cytarabine)(PDF, 120 KB)
Etoposide (po)(PDF, 113 KB)
FLAG(PDF, 121 KB)
FLAG - Idarubicin(PDF, 123 KB)
Gemtuzumab ozogamicin + chemotherapy(PDF, 120 KB)
Gemtuzumab ozogamicin with daunorubicin and cytarabine(PDF, 124 KB)
Gilteritinib(PDF, 113 KB)
High dose cytarabine (ARA C)(PDF, 120 KB)
High dose cytarabine (ARA C) + Amsacrine(PDF, 122 KB)
Hydroxycarbamide(PDF, 115 KB)
Ivosidenib and Azacitidine(PDF, 115 KB)
Liposomal daunorubicin + Cytarabine ( Vyxeos)(PDF, 118 KB)
Low dose cytarabine ( ARA C)(PDF, 115 KB)
Low dose cytarabine ( ARA C) + Venetoclax(PDF, 116 KB)
MACE (Amsacrine, Cytarabine, Etoposide)(PDF, 119 KB)
MEC(PDF, 122 KB)
MidAC(PDF, 120 KB)
Midostaurin + chemo (DA + HD Ara C)(PDF, 125 KB)
Midostaurin (+/- chemotherapy)(PDF, 116 KB)
Mitoxantrone(PDF, 114 KB)
Quizartinib + chemotherapy (DA & high dose Cytarabine)(PDF, 122 KB)
Sorafenib(PDF, 115 KB)
Download all AML SACT formsLast updated: 27th March 2025
Carboplatin-Etoposide(PDF, 201 KB)
Lomustine(PDF, 199 KB)
Procarbazine-Lomustine-Vincristine (PCV)(PDF, 203 KB)
Temozolomide(PDF, 201 KB)
Temozolomide+Radiotherapy(PDF, 203 KB)
Download all Brain/CNS cancers SACT formsLast updated: 25th July 2023
Abemaciclib(PDF, 113 KB)
AC (Doxorubicin - Cyclophosphamide)(PDF, 113 KB)
AC-Docetaxel(PDF, 120 KB)
Alpelisib(PDF, 119 KB)
Atezolizumab - Paclitaxel albumin-bound(PDF, 123 KB)
Capivasertib(PDF, 110 KB)
Capecitabine(PDF, 118 KB)
Capecitabine - Pertuzumab-Trastuzumab(PDF, 121 KB)
Carboplatin(PDF, 112 KB)
Carboplatin, Paclitaxel and EC with Pembrolizumab(PDF, 130 KB)
CMF(PDF, 116 KB)
Cyclophosphamide-Methotrexate(PDF, 114 KB)
Docetaxel(PDF, 114 KB)
Docetaxel-Capecitabine(PDF, 120 KB)
Doxorubicin(PDF, 114 KB)
EC (Epirubicin-Cyclophosphamide)(PDF, 115 KB)
EC-Carboplatin-Paclitaxel(PDF, 122 KB)
EC-Docetaxel(PDF, 120 KB)
EC-Docetaxel-Trastuzumab(PDF, 121 KB)
EC-Paclitaxel(PDF, 120 KB)
EC-Paclitaxel-Trastuzumab(PDF, 121 KB)
EC-PPH(PDF, 120 KB)
EC-TPH(PDF, 120 KB)
Elacestrant(PDF, 109 KB)
Epirubicin(PDF, 117 KB)
Epirubicin-CMF(PDF, 119 KB)
Eribulin(PDF, 113 KB)
Everolimus(PDF, 112 KB)
Gemcitabine - Capecitabine(PDF, 124 KB)
Gemcitabine-Carboplatin(PDF, 123 KB)
Gemcitabine-Paclitaxel(PDF, 120 KB)
Kadcyla® (trastuzumab emtansine)(PDF, 169 KB)
Liposomal doxorubicin (Myocet®)(PDF, 121 KB)
Liposomal doxorubicin (Myocet®)-Cyclophosphamide(PDF, 124 KB)
MMM(PDF, 118 KB)
Neratinib(PDF, 114 KB)
Olaparib(PDF, 115 KB)
Paclitaxel albumin-bound(PDF, 115 KB)
Paclitaxel albumin-bound - Carboplatin(PDF, 120 KB)
Paclitaxel(PDF, 114 KB)
Paclitaxel - Pertuzumab-Trastuzumab(PDF, 123 KB)
Paclitaxel-Trastuzumab(PDF, 119 KB)
Palbociclib(PDF, 116 KB)
Pembrolizumab - Paclitaxel(PDF, 127 KB)
Pembrolizumab – Paclitaxel Albumin Bound(PDF, 129 KB)
Pertuzumab-Trastuzumab(PDF, 113 KB)
Ribociclib(PDF, 117 KB)
Sacituzumab Govitecan(PDF, 119 KB)
Talazoparib(PDF, 110 KB)
TC (Docetaxel-Cyclophosphamide)(PDF, 114 KB)
TCarboH (Docetaxel-Carboplatin-Trastuzumab)(PDF, 121 KB)
TCarboPH (Docetaxel-Carboplatin-Pertuzumab-Trastuzumab)(PDF, 121 KB)
TPH (Docetaxel-Pertuzumab-Trastuzumab)(PDF, 120 KB)
Trastuzumab(PDF, 118 KB)
Trastuzumab Deruxtecan(PDF, 114 KB)
Tucatinib, trastuzumab and capecitabine(PDF, 120 KB)
Vinorelbine (IV)(PDF, 116 KB)
Vinorelbine (Oral)(PDF, 112 KB)
Vinorelbine-Capecitabine(PDF, 119 KB)
Download all Breast cancers SACT formsLast updated: 27 June 2025
Acalabrutinib(PDF, 197 KB)
Bendamustine – Rituximab(PDF, 168 KB)
Chlorambucil(PDF, 197 KB)
Chlorambucil – Obinutuzumab(PDF, 198 KB)
Chlorambucil – Rituximab(PDF, 168 KB)
FCR (Fludarabine – Cyclophosphamide – Rituximab) 3 Days(PDF, 172 KB)
FCR (Fludarabine – Cyclophosphamide – Rituximab) 5 Days(PDF, 172 KB)
Ibrutinib(PDF, 184 KB)
Idelalisib – Rituximab(PDF, 155 KB)
Venetoclax(PDF, 194 KB)
Venetoclax – Ibrutinib(PDF, 183 KB)
Venetoclax – Rituximab(PDF, 167 KB)
Venetoclax – Obinutuzumab(PDF, 201 KB)
Zanubrutinib(PDF, 198 KB)
Download all CLL SACT formsLast update: 20th December 2023
Asciminib(PDF, 163 KB)
Bosutinib(PDF, 168 KB)
Dasatinib(PDF, 169 KB)
Hydroxycarbamide(PDF, 192 KB)
Imatinib(PDF, 168 KB)
Interferon-Alfa(PDF, 189 KB)
Nilotinib(PDF, 194 KB)
Peginterferon-Alfa(PDF, 164 KB)
Ponatinib(PDF, 194 KB)
Download all CML SACT formsLast updated: 10th August 2023
Aflibercept Irinotecan-Fluorouracil Folfiri(PDF, 207 KB)
Bevacizumab Chemotherapy(PDF, 202 KB)
Capecitabine(PDF, 200 KB)
Capecitabine Mitomycin(PDF, 202 KB)
Capecitabine-Mitomycin Radiotherapy(PDF, 206 KB)
Capecitabine and Radiotherapy(PDF, 200 KB)
Carboplatin and Paclitaxel(PDF, 193 KB)
Cetuximab +/- Chemotherapy(PDF, 200 KB)
Cisplatin-Capecitabine(PDF, 202 KB)
Cisplatin-Fluorouracil(PDF, 201 KB)
Encorafenib and Cetuximab(PDF, 189 KB)
Fluorouracil Modified de Gramont(PDF, 200 KB)
Fluorouracil and Folinic Acid Weekly(PDF, 200 KB)
Fluorouracil PVI +/- Radiotherapy(PDF, 201 KB)
Fruquintinib(PDF, 114 KB)
Irinotecan Capecitabine (CAPIRI)(PDF, 191 KB)
Irinotecan Fluorouracil (FOLFIRI)(PDF, 191 KB)
Irinotecan(PDF, 188 KB)
Mitomycin-Fluorouracil Radiotherapy(PDF, 189 KB)
Nivolumab and Ipilimumab(PDF, 186 KB)
Oxaliplatin-Capecitabine (CAPOX)(PDF, 203 KB)
Oxaliplatin-Fluorouracil_(FOLFOX)(PDF, 203 KB)
Oxaliplatin-Irinotecan-Fluorouracil (FOLFOXIRI)(PDF, 206 KB)
Oxaliplatin-Raltitraxed (TOMOX)(PDF, 202 KB)
Panitumumab +/- Chemotherapy(PDF, 201 KB)
Pembrolizumab(PDF, 185 KB)
Raltitrexed(PDF, 198 KB)
Regorafenib(PDF, 199 KB)
Trifluridine and Tipiracil (lonsurf®)(PDF, 199 KB)
Download all Colorectal cancer SACT formsLast updated: 14 July 2022
Imatinib(PDF, 167 KB)
Regorafenib(PDF, 171 KB)
Sunitinib(PDF, 187 KB)
Download all GIST SACT formsLast updated: 18th August 2023
BEP(PDF, 120 KB)
Bevacizumab(PDF, 118 KB)
Carboplatin(PDF, 123 KB)
Carboplatin-Etoposide(PDF, 123 KB)
Carboplatin-Paclitaxel(PDF, 125 KB)
Carboplatin-Paclitaxel - Dostarlimab(PDF, 127 KB)
Carboplatin-Paclitaxel-Pembrolizumab (+/- Bevacizumab)(PDF, 131 KB)
Cisplatin(PDF, 123 KB)
Cisplatin + Radiotherapy(PDF, 123 KB)
Cisplatin-Etoposide(PDF, 124 KB)
Cisplatin-Fluorouracil + Radiotherapy(PDF, 125 KB)
Cisplatin-Paclitaxel(PDF, 125 KB)
Cisplatin-Topotecan(PDF, 124 KB)
Cisplatin-Paclitaxel - Pembrolizumab (+/- Bevacizumab)(PDF, 133 KB)
Cyclophosphamide (oral)(PDF, 118 KB)
Dostarlimab(PDF, 112 KB)
Doxorubicin(PDF, 122 KB)
Doxorubicin-Cisplatin(PDF, 124 KB)
Durvalumab with Carboplatin and Paclitaxel (+/- Olaparib)(PDF, 130 KB)
Etoposide (oral)(PDF, 122 KB)
Gemcitabine(PDF, 124 KB)
Gemcitabine-Carboplatin(PDF, 126 KB)
Gemcitabine-Cisplatin(PDF, 125 KB)
Lenvatinib - Pembrolizumab(PDF, 130 KB)
Niraparib(PDF, 115 KB)
Olaparib(PDF, 115 KB)
Olaparib - Bevacizumab(PDF, 120 KB)
Paclitaxel(PDF, 124 KB)
Pegylated liposomal doxorubicin (Caelyx)(PDF, 125 KB)
Pegylated liposomal doxorubicin (Caelyx) - Carboplatin(PDF, 126 KB)
Rucaparib(PDF, 115 KB)
Trametinib(PDF, 114 KB)
Download all Gynaecological cancers SACT formsLast updated: 15 January 2025
Carboplatin + Radiotherapy(PDF, 189 KB)
Carboplatin-Fluorouracil(PDF, 192 KB)
Carboplatin-Paclitaxel(PDF, 193 KB)
Cetuximab(PDF, 190 KB)
Cetuximab - Carboplatin - Fluorouracil(PDF, 189 KB)
Cetuximab - Cisplatin - Fluorouracil(PDF, 189 KB)
Cetuximab + Radiotherapy(PDF, 190 KB)
Cisplatin + Radiotherapy(PDF, 102 KB)
Cisplatin-Fluorouracil(PDF, 192 KB)
Docetaxel(PDF, 191 KB)
ECarboF (epirubicin-carboplatin-fluorouracil)(PDF, 193 KB)
ECF(PDF, 191 KB)
Gemcitabine-Carboplatin(PDF, 193 KB)
Gemcitabine-Cisplatin(PDF, 192 KB)
Methotrexate(PDF, 190 KB)
Nivolumab(PDF, 183 KB)
Pembrolizumab(PDF, 183 KB)
TCarboF (docetaxel-carboplatin-fluorouracil)(PDF, 194 KB)
TPF (docetaxel-cisplatin-fluorouracil)(PDF, 194 KB)
Download all Head and Neck cancers SACT formsLast updated: 5th September 2022
Atezolizumab and Bevacizumab(PDF, 169 KB)
Cabozantinib(PDF, 123 KB)
Capecitabine +/- Radiotherapy(PDF, 123 KB)
Doxorubicin(PDF, 122 KB)
Durvalumab with Gemcitabine and Cisplatin(PDF, 127 KB)
Durvalumab with Tremelimumab(PDF, 118 KB)
Fluorouracil (Modified de Gramont)(PDF, 124 KB)
FOLFOX (Oxaliplatin and Fluorouracil)(PDF, 127 KB)
FOLFIRINOX(PDF, 123 KB)
Gemcitabine(PDF, 126 KB)
Gemcitabine-Capecitabine(PDF, 117 KB)
Gemcitabine and Carboplatin(PDF, 125 KB)
Gemcitabine and Cisplatin(PDF, 126 KB)
Gemcitabine-Paclitaxel albumin-bound (Abraxane®)(PDF, 124 KB)
Ivosidenib(PDF, 114 KB)
Lenvatinib(PDF, 185 KB)
Pemigatinib(PDF, 121 KB)
Regorafenib(PDF, 122 KB)
Sorafenib(PDF, 125 KB)
Download all HPB SACT formsLast updated: 9th October 2024
Paclitaxel(PDF, 201 KB)
Pegylated Liposomal Doxorubicin (Caelyx)(PDF, 198 KB)
Download all Kaposi Sarcoma SACT formsLast updated 10th August 2023
Afatinib(PDF, 156 KB)
Alectinib(PDF, 166 KB)
Atezolizumab, bevacizumab, carboplatin and paclitaxel(PDF, 137 KB)
Atezolizumab, carboplatin and etoposide(PDF, 132 KB)
Atezolizumab(PDF, 124 KB)
Brigatinib(PDF, 168 KB)
CAP (cyclophosphamide-doxorubicin-cisplatin)(PDF, 174 KB)
Carboplatin, pemetrexed and pembrolizumab(PDF, 205 KB)
Carboplatin, paclitaxel and pembrolizumab(PDF, 173 KB)
Carboplatin-Etoposide(PDF, 170 KB)
Carboplatin-Paclitaxel(PDF, 117 KB)
Carboplatin-Pemetrexed(PDF, 171 KB)
Carboplatin-Vinorelbine(PDF, 158 KB)
CAV (cyclophosphamide-doxorubicin-vincristine)(PDF, 198 KB)
Ceritinib(PDF, 196 KB)
Cisplatin-Etoposide(PDF, 199 KB)
Cisplatin-Pemetrexed(PDF, 200 KB)
Cisplatin- pemetrexed - pembrolizumab(PDF, 202 KB)
Cisplatin-Vinorelbine(PDF, 157 KB)
Crizotinib(PDF, 196 KB)
Dacomitinib(PDF, 195 KB)
Dabrafenib and Trametinib(PDF, 120 KB)
Docetaxel(PDF, 198 KB)
Durvalumab(PDF, 196 KB)
Erlotinib(PDF, 197 KB)
Gefitinib(PDF, 196 KB)
Gemcitabine(PDF, 199 KB)
Gemcitabine-Carboplatin(PDF, 200 KB)
Gemcitabine-Cisplatin(PDF, 200 KB)
Ipilimumab and Nivolumab(PDF, 117 KB)
Larotrectinib(PDF, 192 KB)
Lorlatinib(PDF, 196 KB)
Nintedanib-Docetaxel(PDF, 199 KB)
Nivolumab(PDF, 198 KB)
Nivolumab, Carboplatin and Pemetrexed(PDF, 133 KB)
Nivolumab, Paclitaxel and Carboplatin(PDF, 133 KB)
Osimertinib(PDF, 196 KB)
Pembrolizumab(PDF, 198 KB)
Pemetrexed (maintenance)(PDF, 199 KB)
Ramucirumab-Docetaxel(PDF, 200 KB)
Selpercatinib(PDF, 118 KB)
Sotorasib(PDF, 193 KB)
Tepotinib(PDF, 117 KB)
Topotecan (oral)(PDF, 197 KB)
Vinorelbine (IV)(PDF, 155 KB)
Vinorelbine (oral)(PDF, 155 KB)
Download all Lung cancer SACT formsLast updated: 10th October 2024
Dabrafenib(PDF, 122 KB)
Dabrafenib-Trametinib(PDF, 125 KB)
Dacarbazine(PDF, 122 KB)
Encorafenib-Binimetinib(PDF, 124 KB)
Ipilimumab(PDF, 123 KB)
Ipilimumab-Nivolumab(PDF, 117 KB)
Nivolumab(PDF, 115 KB)
Nivolumab with Relatlimab(PDF, 112 KB)
Pembrolizumab(PDF, 124 KB)
Talimogene laherparepvec (Imlygic®)(PDF, 121 KB)
Tebentafusp(PDF, 116 KB)
Download all melanoma skin cancer SACT formsLast updated: 1 Aug 2025
VCd (Bortezomib, Cyclophosphamide and Dexamethasone)(PDF, 124 KB)
Bortezomib and Dexamethasone(PDF, 122 KB)
KRd (Carfilzomib, Lenalidomide and Dexamethasone)(PDF, 124 KB)
Cyclophosphamide (Oral) +/- Dexamethasone(PDF, 120 KB)
Daratumumab (Monotherapy)(PDF, 119 KB)
DVd (Daratumumab, Bortezomib and Dexamethasone)(PDF, 123 KB)
DVTd (Daratumumab, Bortezomib, Thalidomide and Dexamethasone)(PDF, 123 KB)
DRd (Daratumumab, Lenalidomide and Dexamethasone)(PDF, 123 KB)
Isatuximab, Pomalidomide and Dexamethasone(PDF, 122 KB)
IRd (Ixazomib, Lenalidomide and Dexamethasone)(PDF, 122 KB)
Lenalidomide (Maintenance)(PDF, 120 KB)
Lenalidomide and Dexamethasone(PDF, 121 KB)
PCd (Pomalidomide, Cyclophosphamide and Dexamethasone)(PDF, 119 KB)
Pomalidomide and Dexamethasone(PDF, 121 KB)
Download all Multiple Myeloma SACT formsLast updated: 18 September 2024
Given the substantial number of treatment regimens for Multiple Myeloma, consent forms for the commonly used regimens have been prioritised and uploaded. The remaining forms are in progress and will be accessible in due course.
Anagrelide(PDF, 120 KB)
Busulfan(PDF, 120 KB)
Fedratinib(PDF, 120 KB)
Hydroxycarbamide(PDF, 121 KB)
Imatinib(PDF, 120 KB)
Lenalidomide(PDF, 120 KB)
Momelotinib(PDF, 119 KB)
Peginterferon Alpha(PDF, 120 KB)
Ruxolitinib(PDF, 119 KB)
Thalidomide(PDF, 117 KB)
Download all MPN SACT formsLast updated: 29 October 2024
Capecitabine and Streptozocin(PDF, 120 KB)
Capecitabine and Temozolomide(PDF, 121 KB)
Carboplatin and Etoposide(PDF, 125 KB)
Cisplatin and Etoposide(PDF, 126 KB)
Cyclophosphamide, Vincristine and Dacarbazine (CVD)(PDF, 122 KB)
Etoposide, Doxorubicin, Cisplatin (EDP) +/- Mitotane(PDF, 123 KB)
Everolimus(PDF, 124 KB)
Fluorouracil, Carboplatin and Streptozocin (FCarboSt)(PDF, 121 KB)
Fluorouracil, Cisplatin and Streptozocin (FCisSt)(PDF, 123 KB)
Fluorouracil and Irinotecan (FOLFIRI)(PDF, 126 KB)
Gemcitabine and Capecitabine(PDF, 122 KB)
Mitotane(PDF, 125 KB)
Oxaliplatin, Irinotecan and Fluorouracil (FOLFOXIRI)(PDF, 121 KB)
Sunitinib(PDF, 126 KB)
Temozolomide(PDF, 123 KB)
177-Lutetium Dotatate(PDF, 125 KB)
Download all Neuroendocrine and adrenal SACT formsThe published forms listed here are not exhaustive for neuroendocrine cancers. They reflect mostly (but not exclusively) those regimens for gastroenteropancreatic neuroendocrine tumours.
The regimen-specific consent forms for neuroendocrine cancers of other areas of the body can be found within their respective anatomical groups.
Last updated: 14 May 2024
Capecitabine with Radiotherapy(PDF, 121 KB)
Carboplatin and Capecitabine +/- Radiotherapy(PDF, 124 KB)
Carboplatin and Fluorouracil +/- Radiotherapy(PDF, 126 KB)
CAPOX (Capecitabine and Oxaliplatin)(PDF, 127 KB)
Cisplatin and Capecitabine +/- Radiotherapy(PDF, 124 KB)
Cisplatin and Fluorouracil +/- Radiotherapy(PDF, 125 KB)
Cisplatin-Capecitabine-Trastuzumab(PDF, 123 KB)
Cisplatin-Fluorouracil-Trastuzumab(PDF, 127 KB)
Docetaxel(PDF, 120 KB)
Fluorouracil PVI + Radiotherapy(PDF, 123 KB)
FOLFOX (Fluorouracil and Oxaliplatin) +/- Radiotherapy(PDF, 124 KB)
FOLFIRI (Fluorouracil and Irinotecan)(PDF, 127 KB)
FLOT (Docetaxel, Fluorouracil and Oxaliplatin)(PDF, 125 KB)
HOF (Trastuzumab, Oxaliplatin and Fluorouracil)(PDF, 126 KB)
HOX (Capecitabine, Oxaliplatin and Trastuzumab)(PDF, 125 KB)
Irinotecan(PDF, 124 KB)
Nivolumab(PDF, 115 KB)
Nivolumab with CAPOX (Capecitabine and Oxaliplatin)(PDF, 127 KB)
Nivolumab with FOLFOX (Fluorouracil and Oxaliplatin)(PDF, 126 KB)
Paclitaxel(PDF, 125 KB)
Paclitaxel and Carboplatin +/- Radiotherapy(PDF, 122 KB)
Pembrolizumab(PDF, 118 KB)
Pembrolizumab with CAPOX (Capecitabine and Oxaliplatin)(PDF, 134 KB)
Pembrolizumab with FOLFOX (Fluorouracil and Oxaliplatin)(PDF, 135 KB)
Trifluridine and Tipiracil (Lonsurf)(PDF, 125 KB)
Download all Oesophago-gastric cancers SACT formsLast updated: 23 September 2025
Carboplatin - Etoposide(PDF, 126 KB)
Cyclophosphamide - Etoposide(PDF, 125 KB)
Cyclophosphamide - Oral prednisolone(PDF, 125 KB)
Cyclophosphamide - Topotecan(PDF, 133 KB)
Dacarbazine(PDF, 124 KB)
Doxorubicin - Cisplatin(PDF, 126 KB)
Doxorubicin - Dacarbazine(PDF, 125 KB)
Doxorubicin - Ifosfamide(PDF, 127 KB)
Doxorubicin(PDF, 124 KB)
Etoposide (Oral)(PDF, 123 KB)
Gemcitabine - Dacarbazine(PDF, 133 KB)
Gemcitabine - Docetaxel(PDF, 126 KB)
Gemcitabine(PDF, 125 KB)
IE and Methotrexate(PDF, 134 KB)
IE(PDF, 123 KB)
Ifosfamide(PDF, 125 KB)
IVA(PDF, 124 KB)
IVADo - IVA(PDF, 128 KB)
MAP(PDF, 125 KB)
Mifamurtide(PDF, 118 KB)
Paclitaxel(PDF, 126 KB)
Pegylated Liposomal Doxorubicin and Ifosfamide(PDF, 125 KB)
Pegylated Liposomal Doxorubicin(PDF, 126 KB)
Trabectedine(PDF, 126 KB)
VA(PDF, 125 KB)
VAC(PDF, 124 KB)
VAI(PDF, 123 KB)
VDC and IE(PDF, 128 KB)
VIDE(PDF, 125 KB)
Vincristine and Cyclophosphamide(PDF, 133 KB)
Vinorelbine and Cyclophosphamide(PDF, 125 KB)
Vinorelbine (Oral)(PDF, 124 KB)
VIT(PDF, 117 KB)
Download all Sarcoma SACT formsLast updated: 27 March 2024
Cabozantinib(PDF, 116 KB)
Dabrafenib and Trametinib(PDF, 115 KB)
Entrectinib(PDF, 115 KB)
Larotrectinib(PDF, 112 KB)
Lenvatinib(PDF, 115 KB)
Selpercatinib(PDF, 114 KB)
Sorafenib(PDF, 119 KB)
Vandetanib(PDF, 116 KB)
Download all Thyroid cancer SACT formsLast updated: 18 August 2025
Atezolizumab(PDF, 115 KB)
Avelumab(PDF, 115 KB)
Accelerated M-VAC (methotrexate-vinblastine-doxorubicin-cisplatin)(PDF, 123 KB)
Carboplatin-Paclitaxel(PDF, 117 KB)
Erdafitinib(PDF, 119 KB)
Gemcitabine-Carboplatin(PDF, 117 KB)
Gemcitabine-Cisplatin(PDF, 112 KB)
Gemcitabine-Radiotherapy(PDF, 116 KB)
Mitomycin-Fluorouracil +/- Radiotherapy(PDF, 117 KB)
Nivolumab(PDF, 118 KB)
Paclitaxel(PDF, 115 KB)
Pembrolizumab(PDF, 115 KB)
Download all Urology-Bladder cancers SACT formsLast updated: 1 August 2025
BEP (Bleomycin-Etoposide-Cisplatin)(PDF, 121 KB)
Carboplatin(PDF, 122 KB)
Carboplatin (Etoposide-Bleomycin)(PDF, 124 KB)
EP (Etoposide-Cisplatin)(PDF, 122 KB)
TIP (Paclitaxel-Ifosfamide-Cisplatin)(PDF, 124 KB)
VIP (Etoposide-Ifosfamide-Cisplatin)(PDF, 123 KB)
VeIP (Vinblastine-Ifosfamide-Cisplatin)(PDF, 123 KB)
Download all Urology-Germ cell cancer SACT formsLast updated: 11 June 2024
Abiraterone + Prednisolone(PDF, 185 KB)
Apalutamide(PDF, 181 KB)
Cabazitaxel + Prednisolone(PDF, 187 KB)
Darolutamide(PDF, 181 KB)
Darolutamide and Docetaxel with ADT(PDF, 120 KB)
Docetaxel + Prednisolone(PDF, 187 KB)
Enzalutamide(PDF, 183 KB)
Olaparib(PDF, 183 KB)
Download all Urology-Prostate cancer SACT formsLast updated: 13th May 2024
Generic TKI & IO(PDF, 193 KB)
Avelumab - Axitinib(PDF, 193 KB)
Axitinib(PDF, 188 KB)
Belzutifan(PDF, 123 KB)
Cabozantinib(PDF, 188 KB)
Everolimus(PDF, 188 KB)
Gemcitabine-Doxorubicin(PDF, 190 KB)
Lenvatinib-Everolimus(PDF, 190 KB)
Nivolumab(PDF, 190 KB)
Nivolumab - Ipilimumab(PDF, 189 KB)
Pazopanib(PDF, 184 KB)
Pembrolizumab(PDF, 121 KB)
Sunitinib(PDF, 190 KB)
Tivozanib(PDF, 188 KB)
Download all Urology-Renal cell cancer SACT formsLast updated: 1 August 2025
Carboplatin-Etoposide(PDF, 189 KB)
Cisplatin-Etoposide(PDF, 191 KB)
Download all Urology-Small cell cancer SACT formsLast updated: 10 August 2021
Alemtuzumab(PDF, 668 KB)
Avelumab(PDF, 121 KB)
Bexarotene(PDF, 724 KB)
Carboplatin-Etoposide(PDF, 114 KB)
Capecitabine-Cisplatin(PDF, 122 KB)
Cemiplimab(PDF, 128 KB)
Chlorambucil +/- Prednisolone(PDF, 760 KB)
CHOP 21(PDF, 772 KB)
CHOP 21 + Rituximab (CHOP-R)(PDF, 821 KB)
Cisplatin-Fluorouracil(PDF, 121 KB)
CVP (Cyclophosphamide-Vincristine-Prednisolone)(PDF, 807 KB)
Epirubicin(PDF, 119 KB)
Etoposide (Oral)(PDF, 768 KB)
Gemcitabine(PDF, 780 KB)
Interferon alfa-2a (Roferon-A®)(PDF, 681 KB)
Liposomal Doxorubicin (Caelyx®)(PDF, 850 KB)
Methotrexate (Oral)(PDF, 763 KB)
Pentostatin(PDF, 858 KB)
Rituximab(PDF, 870 KB)
Vismodegib(PDF, 119 KB)
Download all Skin cancer (non-melanoma) SACT formsLast updated: 15 March 2024
Denosumab(PDF, 117 KB)
Zoledronic acid(PDF, 118 KB)
Download all supportive medicines formsLast updated: 8 September 2025
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.
Read a world first population based study of 30-day mortality following SACT in England
View the NHS Trust and national SACT 30-day mortality data published by Public Health England