STATEMENT OF UNDERSTANDING 
The benefits of this experimental study are difficult to predict, and it is possible that no useful 
information will be gained. Participation in the study is strictly voluntary. If you/ your child 
does not wish to volunteer, other options will be discussed and made available. Should any 
problems arise, one of the doctors will make you/your child aware of these developments and 
discuss plans of action. 
1 . I have read the material above and I willingly agree to take part/let my child take part 
in this study. 
2. I have been able to talk as much as I want to with Dr. , who is taking care 
of me or my child , about the reasons for this study and about its risks. 
3. I have been told about the other choices for treatment or for no treatment. 
4. I know that this study may have risks that the doctors do not know about now. 
5. I know that I/my child can withdraw from this study at any time. If this happens. I/my 
child can still be treated at St. Jude. 
6. I know that I/my child will not be paid for being in this study. 
7. I know that if I am injured/my child is injured because of this study. I/my child will not 
get any money for being injured. However, St. Jude will treat the injury, free of charge. 
8. I know that my/my child’s records will not be given to anyone outside the hospital unless 
I agree. I agree that my /my child’s records may be reviewed by agencies such as the 
Food and Drug Administration or the National Cancer Institute. 
9. I know that if I have more questions about this study or about any injury from the 
treatment, I can call at . 
10. I know that I can get more information about my/my child’s rights as a study participant 
by calling the Chairman of the Institutional Review Board at 901/522-0300. 
11. I will receive a signed copy of this statement. 
Patient 
Parent 
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Recombinant DNA Research, Volume 19 
