University of Rochester s2

University of Rochester

Subject Name:

Research Study Name &/or #:

In Case of Emergency

Your safety is very important to us. If you should experience

ANY health-related emergency or have questions during the

study or within one-month after the study ends, please

and give a copy to a family member.

Ray Lyte, MD, PhD – Principal Investigator
Harmony Smith, RN – Study Coordinator
1234567890 (business hours)
999999-9999 (24 Hours)

If you receive health care for any reason, please alert the

provider that you are participating in a Clinical Research Trial

by showing them this card.

Contact us immediately, if you have any signs of infection

(fever, chills, cough) or develop a rash, headache, nausea,

vomiting, confusion, loss of balance, dizziness, difficulty

walking or any other concerning symptom. If you

require hospitalization, please go to Strong Memorial Hospital.

If you are at another facility, please have your provider call to

have you transferred to Strong Hospital by calling: 585.273.4344