Revised 8-26-94 
Exemption (IND) regulation. GenVec, Inc., a biotechnology company (12111 Parklawn 
Drive, Rockville, MD 20852) is responsible for the production of Ad 0V CFTR. 10, and is the 
sponsor of the IND. Dr. Ronald G. Crystal is the Principal Investigator. 
J. I have had the opportunity to ask questions concerning the procedures to be used. I under- 
stand that if I have any further questions concerning the research conducted or any rights I 
may have, I may contact Dr. Ronald G. Crystal or Dr. Noel G. McElvaney (my attending 
physicians) at 212-746-2250. I further understand that I am free to withdraw my consent at 
any time without any penalty or loss of benefits to which I may be otherwise entitled. My 
physician is also free to terminate the study at any time. 
K. There will be no cost to me resulting from care required as part of this study. 
L. In the event that I believe participation in this research study has led to injury, I under- 
stand that I may contact Dr. Ronald G. Crystal or Dr. Noel G. McElvaney (my attending 
physicians) at 212-746-2250 to identify the medical resources which are available to me and 
to assist me in obtaining appropriate medical care. I understand that The Rockefeller Uni- 
versity and the Federal Government do not have any program to provide compensation for 
persons who may experience injury while participating in research projects. 
M. I hereby voluntarily consent to participate in this study and to allow the treatment and 
procedures described above to be performed on me. 
19 
Signature of Subject Date 
In the case of minors, the nature of this study has been explained as fully as is possible given 
their age and verbal assent has been obtained. 
19 
Signature of mother or legal guardian Date 
19 
Signature of father Date 
19 
Witness Date 
(cannot be physician) 
Note: If there is anything that you do not understand about this consent, ask the physician 
for further information. 
Recombinant DNA Research, Volume 20 
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