Description:

AMC-064 Off-Study Summary Form (F50) Study of Blood and Tissue Samples From Patients With Aggressive Non-Hodgkin B-Cell Lymphoma or Hodgkin Lymphoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=7C993962-288D-EDFE-E040-BB89AD43562B

Link:
https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=7C993962-288D-EDFE-E040-BB89AD43562B
Keywords:
  1. 9/19/12 9/19/12 -
  2. 8/24/17 8/24/17 -
Uploaded on:

August 24, 2017

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Creative Commons BY-NC 3.0 Legacy
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Lymphoma NCT00981097 Off Treatment - AMC-064 Off-Study Summary Form (F50) - 2983033v1.0

Please submit this form if the subject has (at least one of the following): 1) completed the post treatment follow-up period per protocol 2) been lost to follow-up 3) has refused follow-up 4) withdrew consent 5) has died. (Note: If all follow-up for a subject has been completed, all subjects (except those never initiating protocol therapy) must have both an Off Protocol Treatment Summary form and Off Study Summary form submitted.)

Ccrr Module For Off Study Summary - Rf50
Off Study Reason

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