Concomitant Medication
Sequence Number
integer
(Trade Name preferred)
text
In the original form this item is hidden.
text
In the original form this item is hidden.
text
In the original form this item is hidden.
text
In the original form this item is hidden.
text
Unit Dose
text
Units of concomitant medication
text
Frequency of concomitant medication
text
Route of concomitant medication
text
Reason for Medication
text
day month year
partialDate
00:00-23:59
time
Concomitant medication prior to study
text
If you tick No, please specify End date and time in the appropriate items.
text
day month year
partialDate
00:00-23:59
time