E3201 Assessment Compliance Form NCT00068692 Comparison of Adjuvant Chemotherapy Regimens in Treating Patients With Stage II or Stage III Rectal Cancer Who Are Receiving Radiation Therapy and Fluorouracil Before or After Surgery Source Form: NCI FormBuilder:

  1. 8/27/12 8/27/12 -
  2. 1/9/15 1/9/15 - Martin Dugas
  3. 6/16/15 6/16/15 -
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June 16, 2015

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Creative Commons BY-NC 3.0 Legacy
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E3201 Assessment Compliance Form NCT00068692

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Time Period (Group 1)
Time Period (Group 2)
Assessment Compliance
Are data amended?
Were both of the quality of life forms completed for this timepoint?
Indicate primary reason why form was not completed (Choose one:)
Was Assessment self-administered? (Choose one:)
How was patient assisted? (Choose one:)
what was the reason for assistance? (Choose one:)
Who assisted or completed assessment? (Choose one:)
Ccrr Module For E3201 Assessment Compliance Form

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