Description:

Southwest Oncology Group S0931 Registration Worksheet Form (Form #62788) Everolimus in Treating Patients With Kidney Cancer Who Have Undergone Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=7DFFD6EC-BC3B-4B34-E040-BB89AD4345BB

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=7DFFD6EC-BC3B-4B34-E040-BB89AD4345BB

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

January 9, 2015

DOI:
No DOI assigned. To request one please log in.
License:
Creative Commons BY-NC 3.0 Legacy
Model comments:

You can comment on the data model here. Via the speech bubbles at the itemgroups and items you can add comments to those specificially.

Itemgroup comments for:

Item comments for:

In order to download data models you must be logged in. Please log in or register for free.

Kidney Cancer NCT01120249 Registration - Southwest Oncology Group S0931 Registration Worksheet Form (Form #62788) - 2992250v1.0

INSTRUCTIONS: All of the information on this Registration Worksheet and the Protocol Eligibility Section must be answered appropriately for a patient to be considered eligible for registration. This Registration Worksheet must be entirely filled out and referred to during the registration. Do NOT submit this worksheet as part of the patient data

Header
Swog Patient Id
SWOG Patient ID Status
Demography
Unnamed2
Unnamed5
Stratification Questions
Unnamed4
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: diabetes, Alzheimer's disease, or heart disease).
Someone may contact me in the future to ask me to allow other uses of my specimens.
I agree to allow my study doctor, or someone approved by my study doctor, to contact me regarding future research involving my participation in this study
Unnamed 7
Has the Southwest Oncology Group Registration Worksheet been completed entirely and is the patient eligible according to the current version of protocol section 5.0
Auxiliary Question

Similar models