Protocol ID93-008 
Page 4 of 5 
reimbursement for expenses from this institution or any financial 
compensation from this institution for such injury. 
11. I have been informed that 1 should inquire of the attending 
physician whether or not there are any services, investigational 
agents or devices, and/or medications being offered by the sponsor 
of this clinical research project at a reduced cost or without cost. 
Should the investigational agent become commercially available 
during the course of this study. 1 understand that I may be 
required to cover the cost of subsequent doses. 
Costs related to my medical care including expensive drugs, tests 
or procedures that may be specifically required by this clinical 
research study shall be my responsibility unless the sponsor or 
other agencies contribute toward said costs. I have been given the 
opportunity to discuss the expenses or costs associated with my 
participation in this research activity. 
12. It is possible that this research project will result in the 
development of beneficial treatments, devices, new drugs, or 
possible patentable procedures, in which event I understand that I 
cannot expect to receive any compensation or benefits from the 
subsequent use of information acquired and developed through my 
participation in this research project. 
13. I may discuss questions or problems during or after this study with 
Dr. Ralph S. Freedman at (713) 792-2770. In addition, I may 
discuss any problems I may have or any questions regarding my 
rights during or after this study with the Chairman of the 
Surveillance Committee at (713) 792-3220 and may in the event 
any problem arises during this clinical research contact the parties 
named above. 
CONSENT: 
Based on the above, I consent to undergo the described procedures 
and investigational therapy and have received a copy of the 
consent form. 
DATE 
SIGNATURE OF PARTICIPANT 
WITNESS OTHER THAN PHYSICIAN SIGNATURE OF PERSON 
INVESTIGATOR RESPONSIBLE & RELATIONSHIP 
Recombinant DNA Research, Volume 19 
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