Description:

SOUTHWEST ONCOLOGY GROUP REGISTRATION FORM Adjuvant Doxorubicin, Cyclophosphamide, and Paclitaxel in Treating Patients With Breast Cancer NCT00070564 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A678842F-926F-5086-E034-0003BA0B1A09

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A678842F-926F-5086-E034-0003BA0B1A09

Keywords:
Versions (2) ▾
  1. 8/26/12
  2. 4/22/15
Uploaded on:

April 22, 2015

DOI:
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License:
Creative Commons BY-NC 3.0 Legacy
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Breast Cancer Registration SWOG NCT00070564

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  1. StudyEvent: SOUTHWEST ONCOLOGY GROUP REGISTRATION FORM
    1. No Instruction available.
Header
Patient characteristics
Patient's Sex
Method of Payment (Method of Payment codes)
Patient's Ethnicity (Ethnicity Spanish/Hispanic Origin codes)
Patient's Race (select all that apply)
Patient Consent For Specimen Use
Patient's initial consent given for specimen use for research on the patient's cancer?
Patient's initial consent given for specimen use for research unrelated to the patient's cancer?
Patient's initial consent given for further contact regarding specimen?