Description:

AMC-058 Adverse Events Form (ADV) Detecting Anal and Genital Human Papillomavirus Infection and Squamous Intraepithelial Lesions in HIV-Positive Patients Enrolled in AIDS Cancer Clinical Trials Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=84C08E62-5708-47AE-E040-BB89AD433E0F

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=84C08E62-5708-47AE-E040-BB89AD433E0F

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Versions (4) ▾
  1. 8/26/12
  2. 8/11/14
  3. 1/9/15
  4. 1/9/15
Uploaded on:

January 9, 2015

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License:
Creative Commons BY-NC 3.0 Legacy
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Aids-related Malignancies NCT00695422 Toxicity - AMC-058 Adverse Events Form (ADV) - 3072852v1.0

No Instruction available.

  1. StudyEvent: AMC-058 Adverse Events Form (ADV)
    1. No Instruction available.
Header
Unnamed2
Was this event expected or anticipated
CTC Adverse Event Attribution Code
Alternative etiology
Action Taken at Time of Adverse Event
If modification was made to study therapy, who initiated modification
Unnamed3
Outcome of Adverse Event
Was this considered a Serious Adverse Event
Seriousness Attributed to Adverse Event (If "Yes" check "Yes" for all that apply Please note that checking "Yes" to any of the events below will require SAE notification according to protocol requirements.)
Comments