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Long NameEnd of Form NCI Standard Template
DefinitionThe collection of CDEs used in the end of form module.
Protocol Long NameNCI Standard Template Forms
Public ID3453266
Module Long NameModule InstructionsQuestionCDECDE Public IDCDE VersionQuestion InstructionsValue Domain Data TypeValue Domain Unit of MeasureDisplay FormatValid ValueForm Value Meaning TextForm Value Meaning Desc.
Optional End of Form QuestionsThere is no requirement for inclusion of these elements on the case report form. If the design and scientific questions posed in the study dictate the need to collect this type of data, these elements should be included.
Responsible Person NameResponsible Person Name20061631.0CHARACTER
Date Form CompletedForm Completion Date20037455.0DATEDD/MON/YYYY
Investigator SignatureInvestigator Signature Text583205.0CHARACTER
Treating physicianTreating Physician Name627493.0CHARACTER
Reviewer NameReviewer Name30088991.0CHARACTER
Review DateCase Report Form Review Date30088971.0DATEDD/MON/YYYY
Date Form AmendedForm Amended Complete Date641663.0DATEMM/DD/YYYY
Person Amending FormCase Report Form Change Person Name32865671.0CHARACTER