Engels

Subject contact worksheet GSK study Prostatic neoplasms NCT00883909

1 Formulieren  
Administrative data
Beschrijving

Administrative data

Center
Beschrijving

Center

Datatype

text

Subject number
Beschrijving

Subject number

Datatype

text

Year 1 - 1st Attempt
Beschrijving

Year 1 - 1st Attempt

Date of Contact Attempt
Beschrijving

Date of Contact Attempt

Datatype

date

Contact Made?
Beschrijving

succesful contact attempt

Datatype

boolean

Year 1 - 2nd Attempt
Beschrijving

Year 1 - 2nd Attempt

Date of Contact Attempt
Beschrijving

Date of Contact Attempt

Datatype

date

Contact Made?
Beschrijving

succesful contact attempt

Datatype

boolean

Year 1 - 3rd Attempt
Beschrijving

Year 1 - 3rd Attempt

Date of Contact Attempt
Beschrijving

Date of Contact Attempt

Datatype

date

Contact Made?
Beschrijving

succesful contact attempt

Datatype

boolean

Date Faxed To Monitor (if 3rd contact attempt is unsuccessful)
Beschrijving

Date Faxed To Monitor

Datatype

date

Year 2 - 1st Attempt
Beschrijving

Year 2 - 1st Attempt

Date of Contact Attempt
Beschrijving

Date of Contact Attempt

Datatype

date

Contact Made?
Beschrijving

succesful contact attempt

Datatype

boolean

Year 2 - 2nd Attempt
Beschrijving

Year 2 - 2nd Attempt

Date of Contact Attempt
Beschrijving

Date of Contact Attempt

Datatype

date

Contact Made?
Beschrijving

succesful contact attempt

Datatype

boolean

Year 2 - 3rd Attempt
Beschrijving

Year 2 - 3rd Attempt

Date of Contact Attempt
Beschrijving

Date of Contact Attempt

Datatype

date

Contact Made?
Beschrijving

succesful contact attempt

Datatype

boolean

Date Faxed To Monitor (if 3rd contact attempt is unsuccessful)
Beschrijving

Date Faxed To Monitor

Datatype

date

Terug naar het begin van de pagina

Similar models

Subject contact worksheet GSK study Prostatic neoplasms NCT00883909

1 Formulieren
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Administrative data
Center
Item
Center
text
Subject number
Item
Subject number
text
Item Group
Year 1 - 1st Attempt
Date of Contact Attempt
Item
Date of Contact Attempt
date
succesful contact attempt
Item
Contact Made?
boolean
Item Group
Year 1 - 2nd Attempt
Date of Contact Attempt
Item
Date of Contact Attempt
date
succesful contact attempt
Item
Contact Made?
boolean
Item Group
Year 1 - 3rd Attempt
Date of Contact Attempt
Item
Date of Contact Attempt
date
succesful contact attempt
Item
Contact Made?
boolean
Date Faxed To Monitor
Item
Date Faxed To Monitor (if 3rd contact attempt is unsuccessful)
date
Item Group
Year 2 - 1st Attempt
Date of Contact Attempt
Item
Date of Contact Attempt
date
succesful contact attempt
Item
Contact Made?
boolean
Item Group
Year 2 - 2nd Attempt
Date of Contact Attempt
Item
Date of Contact Attempt
date
succesful contact attempt
Item
Contact Made?
boolean
Item Group
Year 2 - 3rd Attempt
Date of Contact Attempt
Item
Date of Contact Attempt
date
succesful contact attempt
Item
Contact Made?
boolean
Date Faxed To Monitor
Item
Date Faxed To Monitor (if 3rd contact attempt is unsuccessful)
date
Terug naar het begin van de pagina