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On-Study Form Bladder Cancer NCT00014534 CALGB-90104

- 8/21/15 - 1 form, 3 itemgroups, 61 items, 1 language
Itemgroups: Muscle Invasive Bladder Disease: Prior Treatment Affecting the Bladder, Prior Therapy Date, CCRR MODULE
On-Study Form Bladder Cancer NCT00014534 CALGB-90104 NCT00014534 NCI Cooperative Group On-Study Form-Revised (CALGB-90104) Combination Chemotherapy in Treating Patients With Bladder Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=BE1B6E9C-942E-7181-E034-0003BA12F5E7

On-Study - Superficial Bladder Cancer - On-Study Form - 2019333v2.31 - Superficial Bladder Cancer - On-Study Form

- 1/8/15 - 1 form, 5 itemgroups, 43 items, 1 language
Itemgroups: CRF Header, BLADDER: FORM ADMINISTRATION, BLADDER: DISEASE DESCRIPTION FOR SUPERFICIAL BLADDER CARCINOMA, SUPERFICIAL BLADDER DISEASE: PRIOR TREATMENT AFFECTING THE BLADDER, Comments
Superficial Bladder Cancer - On-Study Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=99CD59C5-A961-3FA4-E034-080020C9C0E0

On-Study - Muscle Invasive Bladder Cancer - On-Study Form - 2019331v2.31 - Muscle Invasive Bladder Cancer - On-Study Form

- 1/8/15 - 1 form, 5 itemgroups, 60 items, 1 language
Itemgroups: CRF Header, BLADDER: FORM ADMINISTRATION, BLADDER: DISEASE DESCRIPTION FOR MUSCLE INVASIVE BLADDER CANCER, MUSCLE INVASIVE BLADDER DISEASE: PRIOR TREATMENT AFFECTING THE BLADDER, Comments
Muscle Invasive Bladder Cancer - On-Study Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=99CD59C5-A95D-3FA4-E034-080020C9C0E0

On-Study - Metastatic Bladder/Urothelial Cancer - On-Study Form - 2019330v2.31 - Metastatic Bladder/Urothelial Cancer - On-Study Form

- 1/8/15 - 1 form, 6 itemgroups, 55 items, 1 language
Itemgroups: CRF Header, BLADDER/UROTHELIAL: FORM ADMINISTRATION, BLADDER/UROTHELIAL: DISEASE DESCRIPTION FOR METASTATIC BLADDER/UROTHELIAL CANCER, BLADDER/UROTHELIAL: SITE(S) OF DISEASE, BLADDER/UROTHELIAL: PRIOR TREATMENT AFFECTING THE BLADDER/UROTHELIUM , Comments
Metastatic Bladder/Urothelial Cancer - On-Study Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=99CD59C5-A95B-3FA4-E034-080020C9C0E0

Bladder Cancer NCT00445601 On-Study - S0337 Cystoscopy and Urine Markers Form - 2389143v1.0 - S0337 Cystoscopy and Urine Markers Form

- 9/20/21 - 1 form, 4 itemgroups, 25 items, 1 language
Itemgroups: Header, Urine Markers, Cytoscopy, Comments
S0337 Cystoscopy and Urine Markers Form Gemcitabine After Surgery in Treating Patients With Newly Diagnosed or Recurrent Bladder Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FE26193B-C3C0-4C67-E034-0003BA3F9857

On-Study Advanced Urinary Tract Cancer CALGB 90601 NCT00942331

- 7/30/15 - 1 form, 7 itemgroups, 65 items, 1 language
Itemgroups: Header Module, Initial Diagnosis, Bladder Malignant Neoplasm, Laboratory Values, Urinalysis, Prior Treatment - Systemic/Intravesical Regimens, Footer Module
CALGB 90601: On-Study Form NCT00942331 Gemcitabine Hydrochloride and Cisplatin With or Without Bevacizumab in Treating Patients With Advanced Urinary Tract Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=653FC86F-74B9-C88B-E040-BB89AD432982

Bladder Cancer NCT00014534 On-Study - NCI Cooperative Group On-Study Form (CALGB-90104) - 2056020v3.0 - NCI Cooperative Group On-Study Form (CALGB-90104)

- 1/8/15 - 1 form, 6 itemgroups, 51 items, 1 language
Itemgroups: MSKCC 00-138; CALGB-90104; ECOG, Form Administration, Disease Description for Muscle Invasive Bladder Cancer, Muscle Invasive Bladder Disease: Prior Treatment Affecting the Bladder, Comments, CCRR MODULE
NCI Cooperative Group On-Study Form (CALGB-90104) Combination Chemotherapy in Treating Patients With Bladder Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A9C0279B-A154-2673-E034-0003BA12F5E7

Visit 1 Run-ln Urinary Tract Infection History NCT01117584

- 1/28/17 - 1 form, 1 itemgroup, 12 items, 1 language
Itemgroup: General Information
NCT01117584 Astellas Phase 2b, Double-Blind, Randomized, Multicenter, Parallel Group, Placebo-Controlled, Dose-Finding Study to Evaluate the Efficacy, Safety and Tolerability of a 12- Week Treatment with ASP1941 in Combination with Metformin in Patients with Type 2 Diabetes Mellitus Who Have Inadequate Glycemic Control on Metformin Alone.

Prostate Cancer NCT00499174 On-Study - NCIC-PR.11 Form 1- Initial Evaluation - 2457017v1.0 - NCIC-PR.11 Form 1- Initial Evaluation

- 9/17/21 - 1 form, 14 itemgroups, 91 items, 1 language
Itemgroups: Patient Information, Race, History and Physical Exam, Disease History, Disease History (continued), Therapy for Lower Urinary Tract Symptoms/Prostate Cancer Prevention/Prostate Cancer, Baseline Symptoms/"Adverse Event" Status, Other Major Medical Problems, Prostate Tissue Samples, Quality of Life Questionnaire, Planned Therapeutic Action, Comments, Supporting Documentation, Form Completion (please print0
NCIC-PR.11 Form 1- Initial Evaluation Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=0EF80EFC-B7A8-1C24-E044-0003BA3F9857

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