STATEMENT OF UNDERSTANDING 
1. I have read the above statement and voluntarily agree to the participation of myself/my 
child in this study/treatment. 
2. I have had adequate opportunity to discuss with Dr. caring 
(name of investigator) 
for me/my child all the purposes and hazards related to this 
study/treatment. 
3. I have been told of alternate courses of action in my/my child’s situation. 
4. I understand that the study/treatment proposed may result in risks which are currently 
unforeseeable. 
5. I understand that I may withdraw myself/my child from this study/treatment at any time 
without jeopardy to further treatment. 
6. I understand that financial compensation is not provided for participation in this 
study/treatment. 
7. I understand that in the event of non-negligent physical injury to myself/my child from 
this study/treatment, financial compensation is not available but medical treatment 
necessary will be provided at no direct cost. 
8. I understand that the information obtained will be kept confidential but that supervised 
review by approved medical representatives of outside institutions or agencies may 
occur. In particular, the chart may be reviewed by an agent of the Food and Drug 
Administration or National Cancer Institute. 
9. I understand that if I have further questions regarding this study/treatment, or concern 
about injury from this study/treatment, I can contact Drs M.K. Brenner or W. Furman 
at 901 522 0300 
10. I understand that further information regarding my/my child’s rights as a research 
participant can be obtained by contacting the Chairman of the Clinical Trials 
Committee, at 901/522-0300. 
[770] 
Recombinant DNA Research, Volume 15 
