ID
2086
Description
S0100 INDUCTION AND CONSOLIDATION TOXICITY FORM Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=AEB46CC2-6DA8-4268-E034-0003BA12F5E7
Link
Keywords
Versions (2)
- 9/19/12 9/19/12 -
- 8/21/17 8/21/17 -
Uploaded on
September 19, 2012
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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Leukemia null Toxicity - S0100 INDUCTION AND CONSOLIDATION TOXICITY FORM - 2071052v3.0
Instructions: Please complete after each cycle of treatment. All dates are MONTH, DAY, YEAR. Explain any blank fields or blank dates in the Comments section. Place an X in appropriate boxes. Circle AMENDED items in red.
- StudyEvent: S0100 INDUCTION AND CONSOLIDATION TOXICITY FORM
Description
Ccrr Module For S0100 Induction And Consolidation Toxicity Form
Description
SWOGPatientID
Data type
text
Description
SWOGStudyNo.
Data type
text
Description
RegistrationStep
Data type
text
Description
PatientInitials
Data type
text
Description
MainMemberInstitution/Affiliate
Data type
text
Description
TreatingPhysician
Data type
text
Alias
- NCI Thesaurus Property
- C25364
- UMLS 2011AA Property
- C0600091
- NCI Thesaurus ObjectClass
- C25741
- UMLS 2011AA ObjectClass
- C0031831
- NCI Thesaurus ObjectClass
- C25705
- UMLS 2011AA ObjectClass
- C1522326
Description
TreatmentPhase
Data type
text
Similar models
Instructions: Please complete after each cycle of treatment. All dates are MONTH, DAY, YEAR. Explain any blank fields or blank dates in the Comments section. Place an X in appropriate boxes. Circle AMENDED items in red.
- StudyEvent: S0100 INDUCTION AND CONSOLIDATION TOXICITY FORM
C1298908 (UMLS 2011AA)
C1705108 (UMLS 2011AA)
C0445356 (UMLS 2011AA)
C0600091 (UMLS 2011AA Property)
C25741 (NCI Thesaurus ObjectClass)
C0031831 (UMLS 2011AA ObjectClass)
C25705 (NCI Thesaurus ObjectClass)
C1522326 (UMLS 2011AA ObjectClass)