Clinical trial: NCT02887586
Section: Participant's Rights
Subsections: Informed Consent Signature Page

Trial name: Intervention effect and mechanism of ear acupuncture on appetite in patients with advanced clinical tumors:
Project undertaking unit: Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences This is a general project of the National Natural Science Foundation of China (Project No. 81573958).  
Statement of Consent I have read the above description of this study and have had the opportunity to discuss and ask questions about the study with my doctor. I propose all questions were answered satisfactorily.  
I am aware of the possible risks and benefits of participating in this study.  
I understand that participation in the study is voluntary and I confirm that there is sufficient time for this consider it and understand that:
- I can always ask my doctor for more information.  
- I can withdraw from this research at any time without discrimination or unfair treatment, and my medical treatment and rights will not be affected.  
I am also aware that if I drop out of the study, especially due to medication, if I report a change in my condition.It will be very beneficial for me and the whole research to complete the corresponding physical examination and physical and chemical examination.  
If I need to take any other medication due to a change in my condition, I
will seek the advice of my doctor beforehand, or tell the truth after the fact to the doctor.  
I will get a signed and dated copy of the informed consent form. At the same time, I allow the National Natural Science Foundation of China, the Ethics Committee Committee and relevant researchers review records.  
Finally, I decided to agree to participate in this study. Patient Signature: ID number: Patient contact number: phone number: Date: Year month day Signature of legal representative: ID number:
contact number: phone number:
Date: Year month day I confirm that the details of this trial, including its rights and possible benefits and risks, have been explained to the patient and given a signed a copy of the informed consent form. Doctor's signature: Date: Year month day Doctor's work phone number: phone number: Office of the Medical Ethics Committee of Xiyuan Hospital Tel: 010- 62835646