NOU 23 ’94 15=46 
FROfl GENZYME ElOTHERPP 
TO 9130149696.59 
PAGE. 01? 
Page 12 
NEW ENGLAND MEDICAL CENTER 
CONSENT FORM 
PROJECT TITLE: Adenovirus -mediated gene transfer for Cystic 
Fibrosis: Safety of administration to the lung. 
II. Aerosol Administration 
PI: Henry L. Dorkin, M.D. 
Cl: Joseph Oren, M.D. 
I understand that as a participant in this study my identity and 
medical records and data relating to this research study will be 
kept confidential, except as required by law, and except for 
inspections by the Food and Drug Administration (FDA) which 
regulates investigational drug studies and the study sponsor. 
Participant Date 
I have fully explained to the 
nature and purpose of the above described study and the risks 
that are involved in its performance. I have answered all 
questions to the best of my ability. 
Principal Investigator or 
Representat i ve 
Witness 
Date 
Recombinant DNA Research, Volume 20 
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