11. 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 Review 
Committee, at (901) 522-0300. 
12. I understand that I can receive a signed copy of this summary statement and a 
separate detailed treatment plan, if I wish. 
Patient 
Investigator 
Date 
Parent or Guardian 
Witness 
Time 
[270] 
Recombinant DNA Research, Volume 17 
