Form EC - Exposure as Collected
EC - Exposure as Collected
What is the[study treatment/dose] label identifier?
* What was the ([intended/planned/actual]) ([study treatment/dose]) (start) date?	01 Jan 2000
What was the ([intended/planned/actual]) ([study treatment/dose]) (end) date?	01 Jan 2000
What was the dose (per administration) (of [study treatment/dose])?
What were the units for the dose?	Choose Capsule Gram International Unit Microgram Milligram Mililiter Puff Tablet
What was the frequency of [study treatment/dose] dosing?	Choose As Needed 4 Times per Day Three Times Daily Twice Daily Daily Every Other Day Every Month
What was the route of administration (of the [study treatment/dose])?	Choose Intralesional Intramuscular Intraocular Intraperitoneal Nasal Oral Rectal Respiratory (Inhalation) Subcutaneous Topical Transdermal Vaginal
Was the dose adjusted?	No  Yes
What was the reason the dose was adjusted?
Was the study treatment interrupted?	No  Yes
What was the duration of the treatment interruption?
What was the interruption duration unit?	Minutes  Hours  Days
Did the subject complete the full course of study treatment?	No  Yes

* Mandatory field