Description:

NCT00268463 NSABP Protocol C-09: Missing Data Form for Quality of Life Questionnaire Oxaliplatin and Capecitabine With or Without an Hepatic Arterial Infusion With Floxuridine in Treating Patients Who Are Undergoing Surgery and/or Ablation for Liver Metastases Due to Colorectal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FC8000EE-F527-1AEA-E034-0003BA3F9857

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FC8000EE-F527-1AEA-E034-0003BA3F9857

Keywords:
Versions (3) ▾
  1. 8/27/12
  2. 1/9/15
  3. 7/3/15
Uploaded on:

July 3, 2015

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License:
Creative Commons BY-NC 3.0 Legacy
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NCT00268463 NSABP Protocol C-09: Missing Data Form for Quality of Life Questionnaire

Submit this form to the NSABP Biostatistical Center whenever a protocol-scheduled Quality of Life Questionnaire (Form QOL) is not filled out by the patient and the assessment

Header
Are Data Amended
Missing Data Form for Quality of Life
Time Point for this Form (mark one)
Reason QOL was Not Assessed During Clinic Visit (Mark the main reason and add comments below.)
Reason QOL was Not Obtained by Phone or Mail (Mark all that apply and add comments below.)

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