The governing body or cancer committee determines the sequence of contacts or governing body for follow-up. The appropriate physician must give permission to contact patients or relatives directly. The method and system must be approved by proper authorities and documented.

The medical staff at the request of the cancer committee may grant blanket permission. This request is usually channeled through the medical executive committee. If the request is denied, blanket permission to contact patients from individual physicians may be necessary. Letters granting permission should be kept on file in the registry.

Blanket permission is most frequently granted when the procedure is well described in the request. Sample letters or dialogue to be used in contacts should be provided to the persons from whom the permission is being requested. The medical staff may wish to impose some restrictions. For instance, the registry staff may be instructed not to mention the patient's diagnosis unless the patient does so first. This restriction has often been applied in the past and can help alleviate problems for the registry staff.

The cancer committee should decide if letters are to be signed by the registry staff or the cancer committee chairperson. A policy should be defined regarding registry staff initiating telephone calls to patients and contacts. Often, cancer registrars are required to identify themselves by another title, rather than using the term cancer registrar.

Occasionally, a patient will contact the registry in response to a follow-up letter, requesting a referral to a new physician, an appointment, or general information. A policy should be established to manage such situations.