Contents

Purpose

Record all ...

Consults eCRF

Field Name

Description / Instructions

Format

Visit Date

The Visit Date is optional on this case report form. Hit the "Tab" key to leave it empty and move to the Evaluation Date.

DD-MMM-YYYY

Evaluation Date

 

DD-MMM-YYYY

Consult Evaluation Type

 

Use pick list.

Notes

Note: If the consult is not applicable or wasn’t done, ‘NA’ if not applicable or ‘Not Done’ with a reason should be entered in the "Notes" section.

200 characters

Legend: (d) derived field, (m) RDC mandatory, (c) for CTEP reporting only.

Validations

Code

Description

Resolutions

CON ?

?

?

Last updated by Yakovlev, Yury (NIH/NCI) [C] on Jun 04, 2020