Concomitant Medications
Sequence Number
text
Trade Name preferred
text
[hidden]
text
[hidden]
text
[hidden]
text
[hidden]
boolean
Unit Dose
text
Concomitant Medication Units
integer
Concomitant Medication Frequency
text
Concomitant Medication Route
text
Reason for Medication
text
Start Date and Time
datetime
Concomitant Medication Taken Prior to Study?
boolean
If no, specify End Date and Time
boolean
End date and time
datetime