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Purpose
This CRF will be used to record that a neurological exam was completed.
Neurological Assessment
Field Name | Description / Instructions | Format |
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Visit Date | The Visit Date is optional on this case report form. Hit the "Tab" key to leave it empty and move to the Date of Vitals field. | DD-MMM-YYYY |
Data Collected | To indicate whether the data was collected for this assessment and time-point | Use pick list. |
Reason if No | If necessary, enter text reason that data is not collected for an identified assessment at this assessment and time point . | 200 characters |
Evaluation Date (m) | Enter the date the neurological exam was performed by the treating investigator. | DD-MMM-YYYY |
Neurological Assessment | Enter the time point per protocol study calendar. For example, "Cycle 2", "End of Treatment". | Use pick list. |
Preference Hand | Select relating to the subject's identification of the preference or dominant hand. Preference hand can be defined as right, left, or both (bilateral). | Use pick list. |
Legend: (m) RDC mandatory
Validations
Code | Description | Resolutions |
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TBD |
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