Gene Therapy for CF using Cationic Liposome Mediated Gene Transfer: Phase I Trial 
example, health insurance) should be sought. 
RIGHT TO WITHDRAW 
I may withdraw from this study at any time. I understand that I am participating on a 
voluntary basis and if I withdraw from this study this will in no way jeopardize my future care 
at the University of Alabama at Birmingham Hospital System and will not be associated with any 
loss of benefits. I also understand that Dr. Eric Sorscher or Dr. James Logan have the right to 
stop my participation in this study at any time. This could occur, for example, if I developed 
an unexpected problem or failed to follow directions. 
AVAILABILITY OF INFORMATION 
If I have any questions regarding this study, I understand that Dr. Eric Sorscher or Dr. 
James Logan will be available to answer my questions. Dr. Sorscher or Dr. Logan can be 
reached at (205) 934-4715. Dr. Sorscher’s paging number is (205) 934-3411 (ask for beeper # 
1135). Dr. Logan’s paging number is (205) 939-9100 (ask for Dr. Logan). 
WITNESS AND SIGNATURE 
I have read and understand all of the information above, and have been given the 
opportunity to ask questions. I voluntarily agree to participate in this study. I understand that I 
will receive a copy of the Consent Form after it is signed. 
PRINTED Name of Patient 
Patient Signature 
Date 
Signature of Person Obtaining Consent 
Date 
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Recombinant DNA Research, Volume 18 
