Description:

Registration Worsksheet for E1308 (Step 0) Paclitaxel, Cisplatin, and Cetuximab Followed By Cetuximab and Intensity-Modulated Radiation Therapy in Treating Patients With HPV-Associated Stage III or Stage IV Cancer of the Oropharynx That Can Be Removed By Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=6F7AB198-2739-A0A1-E040-BB89AD43458F

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=6F7AB198-2739-A0A1-E040-BB89AD43458F

Keywords:
Versions (3) ▾
  1. 9/19/12
  2. 1/9/15
  3. 9/17/21
Uploaded on:

September 17, 2021

DOI:
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License:
Creative Commons BY-NC 3.0 Legacy
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Head and Neck Cancer NCT01084083 Eligibility - Registration Worsksheet for E1308 (Step 0) - 2922435v1.0

No Instruction available.

  1. StudyEvent: Registration Worsksheet for E1308 (Step 0)
    1. No Instruction available.
Eligibility
Has the eligibility checklist been completed
In the opinion of the investigator, is the patient eligible?
Has written informed consent been obtained
Has HIPAA authorization been obtained
I agree to participate in the laboratory research studies that are being done as part of this clinical trial.
I agree my tissue will be submitted for research.
My specimens may be kept for use in research to learn about, prevent, treat, or cure cancer.
My specimens may be kept for use in research about other health problems (for example: causes of heart disease, osteoporosis, diabetes)
Someone from this institution may contact me in the future to ask me to take part in more research.
Patient Demographics / Pre-treatment Characteristics
Patient's Sex
Patient Race (check all that applyU.S. and Canada only)
Patient Ethnicity
Method of payment (check one)

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