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Subject contact worksheet GSK study Prostatic neoplasms NCT00883909

1 forms  
Administrative data
Description

Administrative data

Center
Description

Center

Data type

text

Subject number
Description

Subject number

Data type

text

Year 1 - 1st Attempt
Description

Year 1 - 1st Attempt

Date of Contact Attempt
Description

Date of Contact Attempt

Data type

date

Contact Made?
Description

succesful contact attempt

Data type

boolean

Year 1 - 2nd Attempt
Description

Year 1 - 2nd Attempt

Date of Contact Attempt
Description

Date of Contact Attempt

Data type

date

Contact Made?
Description

succesful contact attempt

Data type

boolean

Year 1 - 3rd Attempt
Description

Year 1 - 3rd Attempt

Date of Contact Attempt
Description

Date of Contact Attempt

Data type

date

Contact Made?
Description

succesful contact attempt

Data type

boolean

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

Date Faxed To Monitor

Data type

date

Year 2 - 1st Attempt
Description

Year 2 - 1st Attempt

Date of Contact Attempt
Description

Date of Contact Attempt

Data type

date

Contact Made?
Description

succesful contact attempt

Data type

boolean

Year 2 - 2nd Attempt
Description

Year 2 - 2nd Attempt

Date of Contact Attempt
Description

Date of Contact Attempt

Data type

date

Contact Made?
Description

succesful contact attempt

Data type

boolean

Year 2 - 3rd Attempt
Description

Year 2 - 3rd Attempt

Date of Contact Attempt
Description

Date of Contact Attempt

Data type

date

Contact Made?
Description

succesful contact attempt

Data type

boolean

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

Date Faxed To Monitor

Data type

date

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Similar models

Subject contact worksheet GSK study Prostatic neoplasms NCT00883909

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
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
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