English

SAE Additional/Follow-Up Information

1 forms  
Administrative data
Description

Administrative data

Subject Identifier
Description

Subject Identifier

Data type

integer

Centre Number
Description

Centre Number

Data type

integer

Randomisation Number
Description

Randomisation Number

Data type

integer

Section 12 SAE Additional/Follow-Up Information
Description

Section 12 SAE Additional/Follow-Up Information

Use this page to provide any additional details on the SAE not already captured on the previous pages
Description

Use this page to provide any additional details on the SAE not already captured on the previous pages

Data type

text

Investigator's signature
Description

confirming that the data on this page is accurate and complete

Data type

text

Investigator's name (print)
Description

Investigator's name (print)

Data type

text

Date
Description

Date

Data type

date

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Similar models

SAE Additional/Follow-Up Information

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative data
Subject Identifier
Item
Subject Identifier
integer
Centre Number
Item
Centre Number
integer
Randomisation Number
Item
Randomisation Number
integer
Item Group
Section 12 SAE Additional/Follow-Up Information
Use this page to provide any additional details on the SAE not already captured on the previous pages
Item
Use this page to provide any additional details on the SAE not already captured on the previous pages
text
Investigator's signature
Item
Investigator's signature
text
Investigator's name (print)
Item
Investigator's name (print)
text
Date
Item
Date
date
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