PATIENT INFORMED CONSENT FORM

Dear participant, we invite you to participate in our study titled “The Frequency and Subtypes of Headache Disorders in the Middle East, North Africa, and Asia.” The title of our study is abbreviated as “Head-MENAA.” The study is an international, multicenter, prospective, cross-sectional study. To participate in our study, it is sufficient that you have a headache, are older than 18 years old, and volunteer to participate in the study. Each participant must give full consent to participate before participating in the study.

Necessary information about the research will be explained to you verbally and offered online. Please listen this information carefully. If you have questions, please let your doctor know. You should freely decide whether or not to participate in the study after the briefing. If you agree to participate in the study, please confirm online. Your decision to participate will not change your medical treatment plan and create a physical risk to you. Your medical data will be kept in absolute confidentiality, and information showing your identity (name, identification number, etc.) will not be requested. You will not be charged or paid any additional fees for your participation in this study. You are free to withdraw from the research at any time without the obligation to provide any explanation. If you decide to withdraw your consent, your registered information will be removed from our database. Your data will not be deleted if you withdraw your consent after the data is published as a scientific article. Only the research team will access data recorded in the “Prevalence and Subtypes of Headache Disorders in the Middle East, North Africa and Asia” data platform. Researchers will protect access to such data. Your consent to participate will guarantee your privacy.

By signing this consent form, I confirm:

• I have thoroughly read the Patient Information Form regarding about the study “Prevalence and Subtypes of Headache Disorders in the Middle East, North Africa, and Asia” and have understood all the information I gave.
• I had ample time to evaluate the information provided and ask all questions regarding “Prevalence and Subtypes of Headache Disorders in the Middle East, North Africa, and Asia” and my participation and got their answers.
• I understand that my health data will be recorded to investigate the frequency and subtypes of headache disorders in the Middle East, North Africa, and Asia.
• I understand that all data collected will be kept confidential, and the results will be used for scientific and research purposes only.
• I understand that no identifying information is required on the internet-based platform of the study.
• I understand that data from the “Prevalence and Subtypes of Headache Disorders in the Middle East, North Africa, and Asia” study, and reports and conclusions from it, will contain only aggregated patient information and may be published as scientific articles.
• I understand that my participation in this study is voluntary and that I can withdraw my consent for any reason without asking for an explanation. I know this situation will not cause any disruption in my health service.
• I understand that I have the right to access, correct, and object to the use of my data.
• I consent to record my health data as part of the study “Prevalence and Subtypes of Headache Disorders in the Middle East, North Africa, and Asia” and to use the data from this study for future scientific research. I know that my personal information will not be disclosed on the internet-based platform of the work or in any future work.

Note: If you join the study from another country except Turkey, please translate the “patient informed consent form” into your native language.