Get Case Report Form (crf) (10 June 2010) - Eutos For Cml - Leukemia-net

Filling out the Case Report Form (CRF) for the EUTOS for CML registry is a crucial step in contributing to our understanding of Chronic Myeloid Leukemia. This user-friendly guide will provide clear instructions on how to accurately complete the form online, ensuring that all necessary information is recorded correctly.

Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to access the CRF and proceed to fill it out in the designated online space.
2. Begin with the Unique Patient Number (UPN) section, entering the identification number assigned to each patient.
3. Provide the patient's basic demographic information, including their date of birth, country of birth, and date of diagnosis. Ensure that all dates are entered in the format dd.mm.yyyy.
4. In the informed consent section, indicate whether the patient signed the consent form, and if so, provide the date of signature.
5. Fill in clinical data before any treatment, including disease-related symptoms and splenic size, ensuring all relevant information is accurately captured.
6. Record the patient's ECOG/WHO score, marital status, gender, and details of any comorbidities that may affect the patient's treatment.
7. After completing Part I (baseline data), proceed to Part II for follow-up information after the first year of treatment. Document any treatments received and their corresponding details.
8. Ensure that all fields regarding cytogenetic and molecular biology tests are filled out based on the patient’s evaluation history.
9. For ongoing data collection, indicate and update any serious adverse events or changes in survival status periodically.
10. Once all sections are completed, utilize the options to save changes, download the form, or share it as necessary.

Complete the Case Report Form online today to contribute valuable information to the registry.