YNU_JEUS/app_home/himed/webapps/crc/comsubjweb/rex/서식 9-04_세포치료제 사용 관련 피험자 서면 동의서.rex

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   기대하기 어려운 상황 또는 대체 치료수단이 없는 상황으로  본 세포치료제가 마지막 치료방법으로 
   강구되고 있는 바 세포치료제의 사용 목적, 예측, 효능, 연구방법, 이상반응, 연구 참여에 따르는 잠재
   적인 이점과 위험 등 모든 정보들에 관하여, 본인은 주치의로부터 자세한 설명을 듣고 충분히 이해하
   였습니다. 

2. 본인은 본 세포치료제에 의한 이상반응으로 피해가 있을 경우, 별도로 이에 대한 책임과 피해보상은
    의뢰기관이 책임지지 아니함을 알고 있습니다. 

3. 본인이 세포치료의 세부 사항에 대해 의문이 있을 경우, 언제라도 주치의 에게 문의할 수 있으며, 본
    치료에 참여하는데 영향을 줄 수 있는 새로운 정보가 입수되면 즉시 본인에게 알려진다는 것을 알고
    있습니다. 

4. 본인의 세포치료제 사용 참여여부 결정은 자발적인 것이며, 치료 기간 중 언제라도 개인적인 사유 등
    으로 지속적인 참여를 중도에 거부하거나, 자유로이 참가를 중단할 수 있으며 이로 인해 진료 및 기타
    어떠한 불이익도 받지 않음을 알고 있습니다. 
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                      주      소 : _____________________________
                      전화번호 :____________________________

법정대리인       성      명  : __________(서명/인)                         ___년___월___일
                      주민번호 : _________-___________(만  세)
                      주      소 :_______________________________
                      전화번호 :_____________________________

주   치   의       성     명 :________________(서명/인)                 ___년___월___일
                      소     속 : ________________________
                      연 락 처 : ________________________     
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