-I 
;>£DICAL RECORD 
CONTINUATION SHEET for either: 
NIH 2514-1, Consent to Participate In A Clinical Research Study 
NIH 2514-2, Minor Patient’s Assent to Participate In A Clinical Research Study 
STUDY NUMBER: CONTINUATION: page 5_ of _2_ pages.; 
follow-up studies. Tests used to decide if your tumor has responded to the therapy will [ 
be similar to those you had before beginning the therapy. 
If your disease recurs after treatment in this protocol, you will be eligible to be 
considered for other protocols at the National Cancer Institute and you will receive j 
treatment as indicated by your disease or referred elsewhere for such treatment. As thiS| 
is a new therapy, side effects that may cause your condition to deteriorate may be en- ! 
countered. You will be watched closely for any side effects. j 
You are free to withdraw your consent to participate in this study at the National Cancerl 
Institute and seek care from any physician at any time. This will involve no loss of 
benefits and will not penalize your care in any way. I 
If you have any questions concerning issues of patients rights you can contact 
, phone# ^ , in the Clinical Center, NIH. 
PATIENT IDENTIFICATION 
CONTINUATION SHEET for either: 
NIH-2514-1 (10-84) 
NIH.2514-2 (10-84) 
P.A : 09-25-0099 
Recombinant DNA Research, Volume 14 
