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  1. 1. Clinical Trial
  2. 2. Routine Documentation
  3. 3. Registry/Cohort Study
  4. 4. Quality Assurance
  5. 5. Data Standard
  6. 6. Patient-Reported Outcome
  7. 7. Medical Specialty
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Eligibility NCT00156338 Fluid Management - Eligibility

- 11/25/11 - 1 form, 2 itemgroups, 5 items, 1 language
Itemgroups: Inclusion Criteria,Exclusion Criteria
ODM derived from http://clinicaltrials.gov/ct2/show/record/NCT00156338

Lymphoma NCT01190449 Response - CALGB 50901 Response Assessment Form - 3210253v1.0 - CALGB 50901 Response Assessment Form

- 9/19/12 - 1 form, 1 itemgroup, 3 items, 1 language
Itemgroup: Response Assessment
CALGB 50901 Response Assessment Form Ofatumumab in Treating Patients With Previously Untreated Stage II, Stage III, or Stage IV Follicular Non-Hodgkin Lymphoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9F3EEDEF-C25E-2960-E040-BB89AD433C2A

Lymphoma NCT00598169 Quality of Life - AMC-053 FACT/GOG-Neurotoxicity Questionnaire - 2798056v1.0 - AMC-053 FACT/GOG-Neurotoxicity Questionnaire

- 9/19/12 - 1 form, 2 itemgroups, 12 items, 1 language
Itemgroups: Additional Concerns,Comments
AMC-053 FACT/GOG-Neurotoxicity Questionnaire Bortezomib, Ifosfamide, Carboplatin, and Etoposide, With or Without Rituximab, in Treating Patients With Relapsed or Refractory AIDS-Related Non-Hodgkin Lymphoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=5B0B1DBC-D18A-02DB-E044-0003BA3F9857

Melanoma (Skin) null Registration - Registration Worksheet (RW) - 2073173v3.0 - Registration Worksheet (RW)

- 9/19/12 - 1 form, 6 itemgroups, 50 items, 1 language
Itemgroups: Patient Information,Inclusion Criteria:,Exclusion Criteria:,Randomization,Stratification,CCRR MODULE
Registration Worksheet (RW) Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B123165F-AFDA-4C3D-E034-0003BA12F5E7

On-Study - PATIENT IDENTIFICATION - 2393050v1.0 - PATIENT IDENTIFICATION

- 9/19/12 - 1 form, 1 itemgroup, 2 items, 1 language
Itemgroup: PATIENT IDENTIFICATION
Patient Medical Record Number form for C3D 3.12 Adopters Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FF06A4FD-E5A6-0776-E034-0003BA3F9857

Pre-Study - NCI Standard Enrollment Template - 2745052v1.0 - NCI Standard Enrollment Template

- 9/19/12 - 1 form, 3 itemgroups, 5 items, 1 language
Itemgroups: Mandatory Enrollment Questions,Conditional Enrollment Questions,Optional Enrollment Questions
The collection of CDEs used in the Enrollment module. The enrollment process occurs when the center's registrar receives and reviews the registration information and makes a determination to accept or not accept the application. If the participant is deemed acceptable, the center enrolls the participant in the study and the coordinating center returns a notification to the registering institution indicating that the proposed participant is enrolled. Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=4C051B61-911C-226D-E044-0003BA3F9857

Sarcoma, Kaposi xxx Transmittal - Specimen Shipping Log - RF31 - 2267315v3.0 - Specimen Shipping Log - RF31

- 9/19/12 - 1 form, 1 itemgroup, 15 items, 1 language
Itemgroup: CCRR MODULE
Specimen Shipping Log - RF31 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=CCE3BE7C-DD79-507C-E034-0003BA12F5E7

Sarcoma NCT00450320 Pathology - AMC-051 AIDS and Cancer Specimen Resource (ACSR) Procurement Form (F37) - 2635824v1.0 - AMC-051 AIDS and Cancer Specimen Resource (ACSR) Procurement Form (F37)

- 9/19/12 - 1 form, 4 itemgroups, 14 items, 1 language
Itemgroups: Header Module,Specimen Procurement,Contact Information,Comments
AMC-051 AIDS and Cancer Specimen Resource (ACSR) Procurement Form (F37) Sirolimus in Treating Patients With HIV-Related Kaposi's Sarcoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=2FDFA89A-059A-6018-E044-0003BA3F9857

Sarcoma NCT01016730 On-Study - AMC-063 Missed Visit Form (F35) - 3020209v1.0 - AMC-063 Missed Visit Form (F35)

- 9/19/12 - 1 form, 3 itemgroups, 6 items, 1 language
Itemgroups: Header Module,Missed Visit Information,Comments
AMC-063 Missed Visit Form (F35) Bortezomib in Treating Patients With Relapsed or Refractory AIDS-Related Kaposi Sarcoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=815FD129-E16B-59A5-E040-BB89AD431E71

Sarcoma NCT01016730 Pathology - AMC-063 AIDS and Cancer Specimen Resource (ACSR) Procurement Form (F37) - 3020081v1.0 - AMC-063 AIDS and Cancer Specimen Resource (ACSR) Procurement Form (F37)

- 9/19/12 - 1 form, 4 itemgroups, 14 items, 1 language
Itemgroups: Header Module,Specimen Procurement,Contact Information,Comments
AMC-063 AIDS and Cancer Specimen Resource (ACSR) Procurement Form (F37) Bortezomib in Treating Patients With Relapsed or Refractory AIDS-Related Kaposi Sarcoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=815F9798-9F3D-E20D-E040-BB89AD435094

Nonneoplastic Condition NCT01057121 On-Study - AMC-070 Evaluation of KS Lesions Form (RK3) - 3146676v1.0 - AMC-070 Evaluation of KS Lesions Form (RK3)

- 9/19/12 - 1 form, 8 itemgroups, 45 items, 1 language
Itemgroups: Header module,EVALUATION OF FOOT KS,EVALUATION OF ORAL CAVITY,GI EVALUATION,PULMONARY EVALUATION,Lesion Measurements,Bronchoscopy and Other Tests,Comments
AMC-070 Evaluation of KS Lesions Form (RK3) Lenalidomide in Treating Patients With AIDS-Related Kaposi Sarcoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=91E37C30-3D1D-3E5F-E040-BB89AD43368B

Sarcoma NCT01016730 Quality of Life - AMC-063 FACT/GOG-Neurotoxicity Questionnaire Form (NTQ) - 3021065v1.0 - AMC-063 FACT/GOG-Neurotoxicity Questionnaire Form (NTQ)

- 9/19/12 - 1 form, 3 itemgroups, 13 items, 1 language
Itemgroups: Visit Number,Additional Concerns,Comments
AMC-063 FACT/GOG-Neurotoxicity Questionnaire Form (NTQ) Bortezomib in Treating Patients With Relapsed or Refractory AIDS-Related Kaposi Sarcoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=816407E2-1423-1A8A-E040-BB89AD433DA9

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