Study Consent Form, Exercises of Surgical Pathology

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Carnegie Mellon University Department of Psychology 5000 Forbes Avenue Pittsburgh, PA 15213-3890 Approved: // Biomedical IRB University of Pittsburgh CONSENT TO ACT AS A SUBJECT IN AN EXPERIMENTAL STUDY TITLE: Social Support, Stress, and Susceptibility to Infection INVESTIGATORS: Sheldon Cohen, Ph.D., Principal Investigator Professor of Psychology Carnegie Mellon University Pittsburgh, PA 15213 (412) 268-2336 William Doyle, PhD. __ Professor of Otolaryngology University of Pittsburgh School of Medicine Department of Otolaryngology/ENT 3705 Fifth Ave. at DeSoto St. . Pittsburgh, PA 15213 (412) 692-5080 Ellen Frank, PhD. Professor of Psychiatry and Psychology ‘Westem Psychiatric Institute & Clinic University of Pittsburgh School of Medicine 3811 O'Hara Street Pittsburgh, PA 15261 (412) 624-2383 David Skoner, MD. Associate Professor of Pediatrics ‘University of Pittsburgh School of Medicine 3705 Fifth Ave. at DeSoto St. Pittsburgh, PA, 15213 (412) 692-5080 SOURCE OF SUPPORT: National Institute of Mental Health Subject’s Initials: