Ccrr Module For Concomitant Medications Excluding Antiretroviral Therapy - Rf09
PatientInitials
text
Study#
Site#
ID#
Cycle#
Firstdayofcycle
Duringthiscycle,hasthesubjectstartedorstoppedanymedications?
Medication(GenericNameOnly)
ACTGDrugCode
Amount
Units
Frequency(perday)
Startedpriortostudy?
DateStarted
Stopped?
DateStopped