VOLUNTARY PARTICIPATION 
Participation in this study is totally voluntary. It has been explained to me that 
I am free to withdraw my consent to participate in this research program at any time 
without jeopardizing my future care at this institution. In the event that I 
withdraw from this study, at any time for whatever reason, clinical data relevant to 
this research will continue to be collected. This can include blood tests, 
vaccination, non-invasive scans, and tumor samples isolated from other procedures 
unrelated to this study. At any time, you may refuse the collection of any of these 
clinical procedures. 
CONFIDENTIALITY 
A record of my progress while on this study will be kept in a confidential file at 
the University of Rochester Cancer Center. The confidentiality of the record is 
carefully guarded and no information by which I may be identified will be released 
or published. I understand that my research records pertaining to this study may be 
reviewed as required by representatives of the Food and Drug Administration (FDA) 
and/or the National Cancer Institute (NCI). Pathology material may be submitted for 
review by pathologists at the University of Rochester, FDA, or NCI. 
*************** 
I have read the contents of this consent form, asked questions, received answers 
concerning areas I did not understand, and upon signing this form, give my consent 
to participate in this program. I will receive a copy of this form, if I so desire. 
Patient/Guardian (Print Name) 
— 
Signature Date 
I 
Auditor Witness - The contents of this consent form were verbally presented to the 
patient/guardian, who had a copy of this form during the 
presentation. 
I.,',- . ■ ■ 
Signature Date 
Physician Investigator - I have verbally presented the consent form to the 
patient/guardian, who had a copy of this form during the 
presentation, and have answered questions completely. 
Signature 
Date 
Principal Investigators: 
el b: 1/7/92 
Scott Freeman, M.D., Cynthi 
M.D., Craig S. McCune, M.D. 
Angel, M.D., Martin Brower, 
Susan Rosenthal , M.D. 
i 
Recombinant DNA Research, Volume 15 
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