If you sign this form, you are willing to join the research project described to you on the other side of 
this page. Your doctors, or the Investigators, did explain the other kinds of treatment that are available to 
you and to others. You should ask the principal Investigator teed below any Questions you may hwe 
this research study. You may ask him/her questions In the future if you do rat tnientand th* ^ 
| being done. The investigators (or doctors) will share with you any new findings that may develop while you 
are' participating In this study. 
The records from this research study will be kept confidential and wffl not be given to anyone who is 
not helping on this study, unless you agree to have the records given out. If the study uses a new drug or 
device that is under the jurisdiction of the Food and Drug Administration (FDA), the FDA government 
officials may look at the relevant part of your m edical records as part of their job to review new druo and 
device Audes. 
If you uant to talk to anyone about this research study because you think you have not been treated 
fairly, or think you have been hurt by joining the study, or you have any other questions about the study, 
! you should call the principal Investigato r. Jonathan W. Simons M.D. ^ 
j 955 ~ 0351 or call the Office of the Joint Committee on Orica! Investigation at 955-3008 or call The 
i Francis Scott Key Medical Center Institutional Review Board for Human Research at 550-1853. Either the 
investigator or the people in the Committee office or IRB office will answer your questions and/or help you 
to find medical care for an Injury you feel you have suffered. The Johns Hopkins University, The Johns 
Hopkins Hospital, The Francis Scott Key Medical Center, and the Federal 
Government do not have any program to provide compensation to you If you experience Injury or other bad 
effects which are not the fault of the investigators. 
You may withdraw from the research study at any time. Even If you do riot want to join the study, or 
If you withdraw from It, you wiQ still have the same quality of medical care available to you at Johns Hopkins 
i or the Frands Scott Key Medical Center. 
If you agree to join this study, please sign your name below. 
NOT VALID WITHOUT THE 
COMMITTEE OR IRB STAMP 
OF CERTIFICATION 
VOID ONE YEAR FROM ABOVE DATE 
RPNNO __ 
StpM« d P t n m m finrtun Man tpptcjNa) 
NOTE; Signed copies of this consent form must be a) retained on file by the Principal Investigator; b> <kp 
patient's medical record; and c) given to the patient. 
Recombinant DNA Research, Volume 17 
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