Procedure Agents Related to Imaging Procedures

This CRF collects collected data on the utilization of procedure agents related to imaging procedures.

This CRF contains two sections. The first section, which collects an indication of whether procedure agents were administered, is always completed. The second section, which is a repeating section, is completed once for each procedure agent that was administered.

"Procedure Agents Used for Imaging [CD_PAUI]" Form Preview

Procedure Agents Used for Imaging

Procedure Agents Related to Imaging Procedures

* Were any procedure agents administered to or taken by the subject?

No Yes

Procedure Agents Related to Imaging Procedures [No information given about how to repeat this Field Group]

What was the agent name?

What was the identifier for the procedure(s) associated with this intervention?

What was the individual dose of the agent per administration?

What is the unit of the agent per administration?

What was the route of administration of the agent?

What was the agent start date?

What was the agent start time?

01 Jan 2000

12:00

* Mandatory field

Package(s)
CD_PAUI.zip