Download:
pdf |
pdfCEIRS Human Influenza Surveillance Study
Form 15A: QC Checklist
The following table will be distributed in a Microsoft Excel format for use at individual medical centers; It is housed in a secure folder.
Study
ID
JHH001
Form 2A:
Eligibility
RM
Form 7A: Sample
Collection
RM
Page 1 of 1
RedCap
QC
RM
AD
RedCap
QC
RM
AD
Form 4A:
Demographics
RM
Form 8A:
Follow Up
RM
RedCap
QC
RM
AD
RedCap
QC
RM
AD
Form 5A: Current
Symptoms
RM
Form 9A: Chart
Review ED
RM
Form 15A: QC Checklist
RedCap
QC
Form 6A:
Medical History
RedCap
QC
RM
AD
RM
RM
AD
RedCap
QC
RM
AD
RedCap
QC
RM
AD
Form 10A: Chart Review
hospitalization
RM
Version 2.0
01/05/2015
| File Type | application/pdf |
| File Title | Data Collection Forms: Johns Hopkins University and Chang Gung University |
| Subject | CEIRS Protocol: 14-0076 |
| Author | Rebecca Medina |
| File Modified | 2015-04-08 |
| File Created | 2015-04-08 |