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Pharmacogenetic research Withdrawal of consent Subject Identification GSK study Chronic Coronary Heart Disease NCT00799903

1 forms  
Withdrawal of consent for PGx (DNA) / Blood sample destruction
Description

Withdrawal of consent for PGx (DNA) / Blood sample destruction

1. Has subject withdrawn consent for PGx research?
Description

withdrawal consent for PGx research

Data type

boolean

If subject has withdrawn consent for PGx research: date informed consent withdrawn
Description

date informed consent withdrawn

Data type

date

2. Has a request been made for blood sample destruction?
Description

request for blood sample destruction

Data type

boolean

If a request has been made for blood sample destruction, check reason
Description

request for blood sample destruction reason

Data type

text

If other reason applied, specify
Description

request for blood sample destruction other reason

Data type

text

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Similar models

Pharmacogenetic research Withdrawal of consent Subject Identification GSK study Chronic Coronary Heart Disease NCT00799903

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Withdrawal of consent for PGx (DNA) / Blood sample destruction
withdrawal consent for PGx research
Item
1. Has subject withdrawn consent for PGx research?
boolean
date informed consent withdrawn
Item
If subject has withdrawn consent for PGx research: date informed consent withdrawn
date
request for blood sample destruction
Item
2. Has a request been made for blood sample destruction?
boolean
Item
If a request has been made for blood sample destruction, check reason
text
undefined item
Code List
If a request has been made for blood sample destruction, check reason
CL Item
Subject withdrew consent for PGx (3)
CL Item
Other (Z)
request for blood sample destruction other reason
Item
If other reason applied, specify
text
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