Description:

RTOG-0522 QP: Radiation Therapy Oncology Group Miscellaneous Patient Assessment Form NCT00265941 Radiation Therapy and Cisplatin With or Without Cetuximab in Treating Patients With Stage III or Stage IV Head and Neck Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F6217E11-C5E7-5543-E034-0003BA3F9857

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=F6217E11-C5E7-5543-E034-0003BA3F9857

Keywords:
Versions (3) ▾
  1. 9/19/12
  2. 1/9/15
  3. 6/21/15
Uploaded on:

June 21, 2015

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License:
Creative Commons BY-NC 3.0 Legacy
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RTOG-0522 QP: Miscellaneous Patient Assessment Form NCT00265941

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  1. StudyEvent: RTOG-0522 QP: Miscellaneous Patient Assessment Form
    1. No Instruction available.
RTOG clinical trial administrative data
Miscellaneous Patient Assessment
SCHEDULED DATA POINT (CHECK ONE)
IF NO PATIENT ASSESSMENT, SPECIFY REASON (CHECK ONE)
WAS INFORMATION OBTAINED BY TELEPHONE INTERVIEW (CHECK ONE)
Normalcy of Diet Rating
Public Eating Rating
Understandability of Speech Rating
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