Information:
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ID
5797
Description
Registerzentrale: Dr. Dickerhoff / Dr. Potthoff, Klinik für Kinder-Onkologie, -Hämatologie und Klinische Immunologie, Universitätsklinikum Düsseldorf
Keywords
Versions (1)
- 9/23/14 9/23/14 - Martin Dugas
Uploaded on
September 23, 2014
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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Registry for Sickle Cell Diseases, 7.consent blood samples
Sichel-Reg, 7. Einverständniserklärung zur Asservierung einer Blutprobe und Durchführung molekulargenetischer Untersuchungen
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Sichel-Reg, 7. Einverständniserklärung zur Asservierung einer Blutprobe und Durchführung molekulargenetischer Untersuchungen
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Consent Forms
Item
text
C0009797 (UMLS CUI-1)
Last Name
Item
Last Name
text
C1301584 (UMLS CUI-1)
First Name
Item
First Name
text
C1443235 (UMLS CUI-1)
Birth Date
Item
Birth Date
date
C0421451 (UMLS CUI-1)
Informed Consent Date
Item
Informed Consent Date
date
C2985782 (UMLS CUI-1)
City and date
Item
text
Signature
Item
text
C1519316 (UMLS CUI-1)
Minor (person)
Item
boolean
C0026193 (UMLS CUI-1)
Legal Guardian
Item
text
C0023226 (UMLS CUI-1)
City and date
Item
text
Signature
Item
text
C1519316 (UMLS CUI-1)
Legal Guardian
Item
text
C0023226 (UMLS CUI-1)
City and date
Item
text
Signature
Item
text
C1519316 (UMLS CUI-1)
Physician consent obtained
Item
Physician consent obtained
text
C1320725 (UMLS CUI-1)
City and date
Item
text
Signature
Item
text
C1519316 (UMLS CUI-1)
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