Medical Record : Continuation Sheet for Consent to Participate in a Clinical Research Study 
Number ^Continuation: page 8 o f 8 pages 
All of my questions have been answered to my satisfaction and I have read the explanation about this 
study and have been given the opportunity to discuss it and to ask questions. I hereby consent to take 
part in this study. 
Signature of Adult Patient & Date Signed 
Signature of Investigator & Date Signed Signature of Witness & Date Signed 
Recombinant DNA Research, Volume 17 
[179] 
