Denise Faustman, MD, PHd
The Faustman Lab at work

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Patient Information Forms

If you are interested in enrolling in the Faustman Lab's clinical trials or would like to schedule an appointment to give a blood sample, please download and complete one of our Patient Information Forms below.

Type 1 Diabetes (T1D)

Download the T1D patient information form as a PDF

Download the T1D patient information form as a Word document


Return the completed form by email, fax or mail:

EMAIL: diabetestrial@partners.org

FAX: 617-726-4095

MAIL:

Dr. Denise Faustman
Massachusetts General Hospital
Immunology Lab - Diabetes Research
CNY, 13th Street, Building 149, Room 3603
Charlestown, MA 02129

 

Other Autoimmune Diseases

Download the general patient information form as a PDF

 

Return the completed form by email, fax or mail:

EMAIL: autoimmunity@partners.org

FAX: 617-726-4095

MAIL:

Dr. Denise Faustman
Massachusetts General Hospital
Immunology Lab
CNY, 13th Street, Building 149, Room 3603
Charlestown, MA 02129