Description:

E3903 Registration Worksheet (step 1) Collecting Tissue Samples From Patients With Leukemia or Other Blood Disorders Planning to Enroll in an ECOG Leukemia Treatment Clinical Trial Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=7586FA81-F57E-351C-E040-BB89AD43544C

Link:
https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=7586FA81-F57E-351C-E040-BB89AD43544C
Keywords:
  1. 9/19/12 9/19/12 -
  2. 1/9/15 1/9/15 - Martin Dugas
Uploaded on:

January 9, 2015

DOI:
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License :
Creative Commons BY-NC 3.0 Legacy
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Leukemia NCT00897767 Eligibility - E3903 Registration Worksheet (step 1) - 2952105v1.0

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  1. StudyEvent: E3903 Registration Worksheet (step 1)
    1. No Instruction available.
Eligibility
Has the patient registered to or started treatment on the respective treatment trial
Has written informed consent been obtained
Has HIPAA authorization been obtained
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 from this institution may contact me in the future to ask me to take part in more research.
I agree research specimens may be collected with a swab.
I agree to provide additional blood for research.

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