Wellness League Informed Consent
This form will serve as your entrance to the Wellness League, the Fatty Liver Foundation’s (FLF) patient navigator program designed to help you understand, monitor, and manage your NAFLD/NASH.

In this first step, you will be joining a patient support system. Only patients, family, or caregivers will be allowed to join the Wellness League patient ecosystem.
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Wellness League Informed Consent
Thank you for your interest in joining the Wellness League, FLF's patient navigator program designed to help you diagnose, monitor, and manage your NAFLD/NASH. There are two parts to the initial interview: the first section will collect information about your health history and the second section will collect information about your current lifestyle and diet. Our primary goal in collecting this information is to better serve your individual needs. In the hopes of supporting your personal journey with NAFLD/NASH, we will do our best to connect you to resources both online and in your area, provide regular check-ins with our staff, and link you to opportunities for clinical trials. The larger goal of the Wellness League is to build a nationwide community and database of NAFLD/NASH patients who can be easily identified and made aware of new opportunities available for treatment and disease management. More broadly, FLF aims to increase awareness of NAFLD/NASH and improve early detection and screening. By joining the Wellness League, you will be helping to strengthen our collective voice.

The extent to which you choose to engage with our services is entirely up to you and you may change your preferences at any time. Your personal and medical information will be kept confidential and will never be shared with anyone outside of FLF. Though FLF may aggregate data collected through the Wellness League for scientific or advocacy purposes, any information shared with the general public will be de-identified. If you would not like your data to be included in these anonymized reports, you may choose to opt out without any consequence to your continued participation in the Wellness League. There are no costs to joining the Wellness League, nor will you be compensated monetarily for participating. If at any point you do not want to disclose certain information or you would like to remove all or some of your information from our database, you may do so by informing any of our staff.

If you have any questions, please reach out via email to screening@fattyliverfoundation.org.

Clicking "Yes" below and submitting the form indicates you have read the entirety of it and that you are in agreement with its provisions. It is not binding, and your preferences may be changed at any time by informing any of our staff.
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