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CONFIDENTIAL DISCLOSURE

LIMITED USE AGREEMENT

for the Pediatric Quality of Life InventoryTM PedsQLTM Pediatric Pain Coping Inventory
(PedsQLTM Pediatric Pain Coping Inventory™)

THIS AGREEMENT WILL EXPIRE 7 DAYS AFTER RECEIPT.
THE COPY OF THE PedsQLTM Pediatric Pain Coping Inventory SUPPLIED WITH THIS AGREEMENT MAY ONLY BE USED FOR EXAMINATION PURPOSES.
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YOUR ACQUISITION OF AN EXAMINATION COPY OF PEDSQLTM PEDIATRIC PAIN COPING INVENTORY SIGNIFIES YOUR FULL AGREEMENT TO THE FOLLOWING CONDITIONS:

This License Agreement is for your limited use of the Pediatric Quality of Life InventoryTM PedsQLTM Pediatric Pain Coping Inventory (PedsQLTM Pediatric Pain Coping Inventory™) , copyright ©1998, JW Varni, PhD, All Rights Reserved.

This Agreement provides you with a personal, non-transferable, royalty-free, non-exclusive right and license to use the PedsQLTM Pediatric Pain Coping Inventory for limited purpose of examining the suitability of the PedsQLTM Pediatric Pain Coping Inventory for subsequent research and/or clinical use. This Agreement does not include: (1) any license for use of the PedsQLTM Pediatric Pain Coping Inventory in research or in clinical practice(2) any license to sell or sublicense use of the PedsQLTM Pediatric Pain Coping Inventory . The PedsQLTM Pediatric Pain Coping Inventory may be examined only by persons whom you employ or whom you engage as independent contractors. You assume all risk for use of the PedsQLTM Pediatric Pain Coping Inventory. This License only entitles you to obtain and use, for examination purposes, a single copy of the PedsQLTM Pediatric Pain Coping Inventory.

You are not authorized to modify, retype, translate, copy or otherwise duplicate the PedsQLTM Pediatric Pain Coping Inventory except with the further and prior written permission of LICENSOR (Mapi Research Trust on behalf of Dr. James Varni).

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