Cayo Santiago

Waiver And Assumption Of Risk

UNIVERSITY OF PUERTO RICO
MEDICAL SCIENCES CAMPUS
CARIBBEAN PRIMATE RESEARCH CENTER
CPRC Guidelines for the Management of Cercopithecine Herpes Virus 1
(B-Virus) Exposure and Post Exposure in Humans

The undersigned individual _______________________ certifies that s(he) has read and understood the CPRC Guidelines for the Management of Cercopithecine Herpes Virus 1 (B-Virus) Exposure and Post Exposure in Humans. I hereby waive and release all claims against the University of Puerto Rico and the Caribbean Primate Research Center by any bodily injury and/or death which may arise by complying with these guidelines, or by not adhering properly to these guidelines.



Print Name:____________________________________________

Signature:_____________________________________________

Address:_______________________________________________

Date:__________________________________________________