Description:

AMC-076 Adverse Events Form (ADV) Infrared Coagulator Ablation or Observation in Preventing Anal Cancer in HIV-Positive Patients With Anal Neoplasia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9A357A24-852A-31A4-E040-BB89AD4314CA

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9A357A24-852A-31A4-E040-BB89AD4314CA

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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

DOI:
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License:
Creative Commons BY-NC 3.0 Legacy
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Anal Cancer NCT01164722 Toxicity - AMC-076 Adverse Events Form (ADV) - 3184612v1.0

No Instruction available.

  1. StudyEvent: AMC-076 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 (check "Yes" for all that apply)
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