ec-select>
  <div style="margin-bottom: 20px;">        </div>
  <label style="display: block;">Collection Center</label>           <div useros-field-inputerror field="ectx.customFields.preferred_collection_site" type="user">
        econsentForm.visit_center"> </div>
   <div style="display: inline-block; margin-right: 20px;">   </div>
           <os-sites name="preferred_collection_site" ng-model="ectx.customFields.preferred_collection_site" ></os-sites>
            </div>
            <div os-field-error field="econsentForm.preferred_collection_site"> </div>
          </div>
        </div>

    <div style="margin-bottom: 20px;">
          <label style="display: block;">Visit Center</label>
          <div user-input field="ectx.customFields.visit_center">
            <div style="display: inline-block; margin-right: 20px;">
              <ec-select ng-model="ectx.customFields.visit_center" required>
                <custom-field>consent_custom_fields.visit_center</custom-field>
              </ec-select>
            </div>
            <div os-field-error field="econsentForm.visit_center"> </div>
          </div>
        </div>

 <ol>
	<li>
		<u>You will be asked to donate a blood sample (approximately 3 tablespoons) and urine sample.</u> If these samples are not collected today, they may be collected at a future time when you have a blood draw ordered by your doctor or a separate appointment that is convenient for you. In some cases, we may ask you for a saliva (spit) or buccal (cheek swab) sample. We may also use blood, urine, or tissue samples collected as part of your clinical care now or in the future that would otherwise be thrown away.
	</li>
	<li>
		<u>We will request information about you and your health.  We will collect your name, address and other contact information.</u> We will use your electronic health records now and, in the future, to update your health information. We will store some of your health information, including your name, contact information, and medical history, in the Columbia Biobank database.  Biobank staff will make a note that you are a participant in the biobank in your electronic health record.
	</li>
	<ec-print-page-break></ec-print-page-break>
	<li>
		<u>We may contact you in the future.</u> We may ask you to complete additional questionnaires about your health or contact you to get additional information and ask if you are interested in joining other research studies. We may also contact you for another biological sample. We may ask for additional samples in order to study changes in your sample over time, or because we used up the first sample you provided. If we ask you for another sample, you may always say no.
	</li>
	<li>
		<u>Your coded samples, health information, and the research results may be shared with the scientific research community.</u> A science and ethics committee will review each request for data access. We will not give researchers outside of Columbia University Irving Medical Center-NewYork Presbyterian your name or any other information that could directly identify you.
	</li>
</ol>

<div ng-show="ectx.statements.C0003=='N'" >
 <p> .... </p>
 <label class="radio-inline">
  ......
 </label>
</div>

<div class="clearfix" consent-question="M001
	<li>
		<u>We may contact you in the future.</u> We may ask you to complete additional questionnaires about your health or contact you to get additional information and ask if you are interested in joining other research studies. We may also contact you for another biological sample. We may ask for additional samples in order to study changes in your sample over time, or because we used up the first sample you provided. If we ask you for another sample, you may always say no.
	</li>
	<li>
		<u>Your coded samples, health information, and the research results may be shared with the scientific research community.</u> A science and ethics committee will review each request for data access. We will not give researchers outside of Columbia University Irving Medical Center-NewYork Presbyterian your name or any other information that could directly identify you.
	</li>
</ol>

<div>
 <textarea class="form-control" ng-model="ectx.customFields.parentGuardianName" rows="1" ng-required="cpr.participant.gender == 'Male'"> </textarea>
</div>

<div>>
     <div>
      <ec-signature-file-uploader file="ectx.customFields.signedConsentFile" name="signaturesignedConsentFile" imageng-required="(ectx.customFields.signature" ng-required="==null && ectx.customFields.signatureAuthRep ==null)"></ec-file-signature>uploader>
   </div>

<div style="width: 45%; float: left;">
  <label class="control-label">
   <span>Upload Paper Consent</span></label>
   <div user-input field="ectx.customFields.signedConsentFile" type="file">               <td>
               <div>       <ec-file-uploader file="ectx.customFields.signedConsentFile" name="signedConsentFile" ng-required="(ectx.customFields.signature==null && ectx.customFields.signatureAuthRep ==null)"></ec-file-uploader><strong>Last Name:</strong> {{cpr.participant.lastName}}
                  </div>td>
            </div>     <div os-field-error field="econsentForm.signedConsentFile"></div>
</div>

<ec-page-nav-buttons>
  <next>Siguiente</next>
<previous>Página Anterior</previous>
<save>Guardar</save>
<cancel>Cancelar</cancel>
</ec-page-nav-buttons>

<ec-print-template>
<div>
  <ec-page-header>
    <div class="clearfix" style="border-bottom: 1px solid #ddd; position:relative;height: 70px; background: #fff; display: inline-block; width: 100%; padding: 8px 8px;">
      <div style="float: left;"><td>
                     <strong>First Name:</strong> {{cpr.participant.firstName}}
                  </td>
               </tr>
            </table>
<img style="position: absolute; z-index: 1000; height: 60px; width: 450px;" src="https://bb.cuimc.columbia.edu/os-test/logo/RS2133_RS460_Columbia_CUIMC_H_B_RGB_A.png">
      </div>
    </div>
  </ec-page-header>

  <ec-page-footer> <!-- #else --> // This section will be used to print the information while printing
            <table style="border-topwidth: 80%; border: 2px solid #dddblack; position:relative;height: 70px; display: inline-block; width: 100%; padding: 8px 8px;">margin-left: auto;" ng-if="1 == 0">
               <tr>
<tbody>         <tr>         <td>
 <td style="text-align: left;">             <img style="height: 70px; width: 300px;" <strong>Last src="httpsName:<//bb.cuimc.columbia.edu/os-test/logo/cumc_stamp_hiccc.png">strong> $cpr.participant.lastName
                  </td>
                  <td>
<td style="text-align: right; padding: 10px;">                    <div id="osPageCounter" style="position: absolute; bottom: 12px; right: 5px;"> </div><strong>First Name:</strong> $cpr.participant.firstName
                  </td>
               </tr>
       </tbody>     </table>
     </ec-page-footer>
</div>
</ec-print-template>
     <!-- #end -->
         </div>