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No Instruction available.

1 forms  
  1. StudyEvent: Specimen Procurement Form - RF36
    1. No Instruction available.
Ccrr Module For Specimen Procurement Form - Rf36
Description

Ccrr Module For Specimen Procurement Form - Rf36

Patient Initials
Description

PatientInitials

Data type

text

Study#
Description

Study#

Data type

text

Site#
Description

Site#

Data type

text

ID#
Description

ID#

Data type

text

Cycle #
Description

Cycle#

Data type

text

Seq #
Description

Seq#

Data type

text

Date Specimen Obtained
Description

DateSpecimenObtained

Data type

text

Were specimens collected
Description

Werespecimenscollected

Data type

text

Specimen Type Code
Description

SpecimenTypeCode

Data type

text

Specify Other
Description

SpecifyOther

Data type

text

Total Volume (ml)
Description

TotalVolume(ml)

Data type

text

Stored/Shipped Code
Description

Stored/ShippedCode

Data type

text

Specify Other
Description

SpecifyOther

Data type

text

Reason Sample Obtained Code
Description

ReasonSampleObtainedCode

Data type

text

Specify Other
Description

SpecifyOther

Data type

text

Person Responsible for Sample(s)
Description

PersonResponsibleforSample(s)

Data type

text

Date Form Completed
Description

DateFormCompleted

Data type

text

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Similar models

No Instruction available.

1 forms
  1. StudyEvent: Specimen Procurement Form - RF36
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Ccrr Module For Specimen Procurement Form - Rf36
PatientInitials
Item
Patient Initials
text
Study#
Item
Study#
text
Site#
Item
Site#
text
ID#
Item
ID#
text
Cycle#
Item
Cycle #
text
Seq#
Item
Seq #
text
DateSpecimenObtained
Item
Date Specimen Obtained
text
Item
Were specimens collected
text
CL.1
Code List
Were specimens collected
CL Item
Yes (Yes)
CL Item
No (No)
SpecimenTypeCode
Item
Specimen Type Code
text
SpecifyOther
Item
Specify Other
text
TotalVolume(ml)
Item
Total Volume (ml)
text
Stored/ShippedCode
Item
Stored/Shipped Code
text
SpecifyOther
Item
Specify Other
text
ReasonSampleObtainedCode
Item
Reason Sample Obtained Code
text
SpecifyOther
Item
Specify Other
text
PersonResponsibleforSample(s)
Item
Person Responsible for Sample(s)
text
DateFormCompleted
Item
Date Form Completed
text
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