Inform Enrollment
Date of Visit/ Assessment
Subject identification
Demography
Enter subject’s date of birth, if you are unable to provide a full date of birth, enter a partial date of birth.
date
Date of birth - Complete
date
Date of birth - Imputed
date
Sex
text
Ethnicity
integer
Check all that apply
integer
Subject Status
text
Cardiovascular medical conditions
Specific cardiovascular medical condition
integer
Cardiovascular medical condition status
integer
Specify other cardiovascular medical condition
text
Medical conditions
Specific medical condition
integer
Medical condition status
integer
Ocular medical conditions - Right Eye
Specific ocular medical condition - Right Eye
integer
Ocular medical condition status - Right Eye
integer
Ocular medical conditions - Left Eye
Specific ocular medical condition - Left Eye
integer
Ocular medical condition status - Left Eye
integer
Other ocular conditions
Sequence number
text
Specific other ocular condition
text
Other ocular condition status
integer
Eye
integer