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Ion of the 10-day post-treatment observation period. Study Number must be recorded on all pages of Form DQT-3. Attach lab reports and other information. 2. If Reward7 was not used under the assigned Study Number, fill out only the Site Information portion on this page, and skip to the end of page 3 and fill out only the "Negative Report" section. 3. Investigator should keep the original on file, and send a copy to the Study Monitor. Within 10 days of receipt, the Study Monitor should send a copy.

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