Visit Checklist: CRF QMCR University of Alberta

ID

17005

Description

ODM derived from: http://www.qmcr.ualberta.ca/en/ToolsandTemplates/CaseReportFormCRFTemplates.aspx. Template Name: Visit Checklist. University of Alberta, Quality Management in Clinical Research. Copyright: 2002-2016 University of Alberta.

Link

http://www.qmcr.ualberta.ca/en/ToolsandTemplates/CaseReportFormCRFTemplates.aspx

Keywords

Clinical Trial

Progress Note

8/20/16 8/20/16 -

Uploaded on

August 20, 2016

DOI

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License

Creative Commons BY-NC 3.0

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1 forms

StudyEvent: ODM
1. Visit Checklist: CRF QMCR University of Alberta

Name

Type

Description | Question | Decode (Coded Value)

Data type

Alias

General Information

Item Group

General Information

Study Name

Item

Study Name

text

Site Number

Item

Site Number

integer

Pt_ID

Item

Pt_ID

integer

Visit Date

Item

Visit Date

date

Visit Checklist

Item Group

Visit Checklist

1. Did the participant attend this visit?

Item

1. Did the participant attend this visit?

text

1. Did the participant attend this visit?

Code List

1. Did the participant attend this visit?

CL Item

Yes (If yes, continue) (1)

CL Item

No (2)

2. Please check all the assessments completed at this visit

Item

2. Please check all the assessments completed at this visit: Demographics

boolean