MEDICAL 
RECORD 
CONTINUATION SHEET for either: 
NIH 2514-1, Consent to Participate In A Clinical Research Study 
NIH 2514-2, Minor Patient's Assent to Participate In A Clinical Research Study 
IM 
STUDYNUMBER CONTINUATION: page of pages. 
Confidentiality of Data 
This clinical procedure has attracted a great deal of attention from the media. We will make 
every effort to protect the confidentiality of you and your family. However, because of this media 
interest there is a greater risk than usual that information concerning your treatment will appear 
publicly without your consent. 
You are free to withdraw your consent to participate in this study at the NIH and seek care 
from any physician at any time. This will involve no loss of benefits and will not penalize your care in 
any way. 
PATIENT IDENTIFICATION 
CONTINUATION SHEET for either 
NIH-2514-1 (10-84) 
Recombinant DNA Research, Volume 15 
[831] 
i 
