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0247 Forms

 0247 Phase II Rectal
  1. Complete Forms Package
  2. A5 Demographic Data Form
  3. A5 Instructions
  4. I1 Initial Evaluation Form
  5. CS Quality of Life Cover Sheet
  6. QF EORTC QLQ-30
  7. PF EORTC QLQ-CR-38
  8. FS Pretreatment Questionnaire-Female
  9. FL Pretreatment Questionnaire-Male
  10. FA Sexual Adjustment Questionnaire (Pretreatment female)
  11. SA Sexual Adjustment Questionnaire (Pretreatment male)
  12. FC Sexual Adjustment Questionnaire (Followup female)
  13. SC Sexual Adjustment Questionnaire (Followup male)
  14. TF Preoperative Chemotherapy Treatment Form
  15. AE Adverse Event Evaluation Form
  16. SF Postoperative Chemotherapy Treatment Form
  17. F1 Followup Form
    (0247 F1 form is available for electronic data submission)
  18. S1 Surgery Form
  19. T1 Radiotherapy Summary Form
  20. T2 Protocol Treatment Form
  21. T4 Protocol Calculation Form
  22. Dosimetry Transmittal Form
  23. Forms Package Index



  RTOG Meeting | June 24-27 2004 Capital Hilton, Washington D.C.