Description:

NSABP PROTOCOL C-08 ADVERSE EVENT FORM Fluorouracil, Leucovorin, and Oxaliplatin With or Without Bevacizumab in Treating Patients Who Have Undergone Surgery for Stage II or Stage III Colon Cancer NCT00096278 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=EF511EA4-0C5D-199B-E034-0003BA3F9857

Link:
https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=EF511EA4-0C5D-199B-E034-0003BA3F9857
Keywords:
  1. 8/27/12 8/27/12 -
  2. 1/8/15 1/8/15 - Martin Dugas
  3. 1/9/15 1/9/15 - Martin Dugas
  4. 3/23/15 3/23/15 - Martin Dugas
Uploaded on:

March 23, 2015

DOI:
To request one please log in.
License :
Creative Commons BY-NC 3.0 Legacy
Model comments :

You can comment on the data model here. Via the speech bubbles at the itemgroups and items you can add comments to those specificially.

Itemgroup comments for :

Item comments for :

In order to download data models you must be logged in. Please log in or register for free.

Colorectal Cancer (NSABP NCT00096278)

Fax to 412-622-2111

  1. StudyEvent: NSABP PROTOCOL C-08 ADVERSE EVENT FORM
    1. Fax to 412-622-2111
Header
Are data amended? (check box if yes, and circle amended items)
Adverse event
Type of Report
Was patient hospitalized for 24 hours or more?
Any grade 3, 4, or 5 adverse event (AE) or any grade >= 2 neurologic AE?

Similar models

Please use this form for feedback, questions and suggestions for improvements.

Fields marked with * are required.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial