Have any medications/treatment been administered during study period?
Item
Have any medications/treatment been administered during study period?
boolean
If Yes, please record the concomitant medication details below
Item
If Yes, please record the concomitant medication details below
text
Trade/Generic Name
Item
Trade/Generic Name
text
Item
Medical Indication
text
Code List
Medical Indication
If Other, specify
Item
If Other, specify
text
Total Daily Dose
Item
Total Daily Dose
text
CL Item
Intramuscular (3)
Start Date of Medication
Item
Start Date of Medication
date
End Date of Medication
Item
End Date of Medication
date
Ongoing at the end of study?
Item
Ongoing at the end of study?
boolean