English

Pharmacogenetic research GSK study Chronic Coronary Heart Disease NCT00799903

1 forms  
Pharmacogenetic (PGx) research consent / Blood sample collection
Description

Pharmacogenetic (PGx) research consent / Blood sample collection

1. Has informed consent been obtained for PGx research?
Description

Informed consent

Data type

boolean

If yes, record: Date informed consent obtained for PGx research
Description

Informed consent date

Data type

date

Has sample been collected for PGx research?
Description

Answer only if informed consent was obtained for PGx research.

Data type

boolean

If yes, record date sample taken
Description

date sample taken

Data type

date

If no informed consent for PGx research was obtained, check reason
Description

reason absence informed consent

Data type

text

If other reason, specify:
Description

reason absence informed consent specification

Data type

text

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Similar models

Pharmacogenetic research GSK study Chronic Coronary Heart Disease NCT00799903

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Pharmacogenetic (PGx) research consent / Blood sample collection
Informed consent
Item
1. Has informed consent been obtained for PGx research?
boolean
Informed consent date
Item
If yes, record: Date informed consent obtained for PGx research
date
sample collection
Item
Has sample been collected for PGx research?
boolean
date sample taken
Item
If yes, record date sample taken
date
Item
If no informed consent for PGx research was obtained, check reason
text
reason absence informed consent
Code List
If no informed consent for PGx research was obtained, check reason
CL Item
Subject declined (1)
CL Item
Subject not asked by Investigator (2)
CL Item
Other (Z)
reason absence informed consent specification
Item
If other reason, specify:
text
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