WITNESS AND SIGNATURES 
My signature on this consent form indicates that I have read and understand the 
purpose, procedures, risks, and benefits of participation in this study. I have been given 
the opportunity to ask questions and my decision to participate is based on the 
information provided. A copy of this form will be given to me. 
or 
Patient's signature indicating consent 
check box if 
verbal assent 
obtained by 
investigator 
Witness as to Voluntary Signature 
Date 
[422] 
Recombinant DNA Research, Volume 17 
