Download protocol review and monitoring committee

PROTOCOL REVIEW AND MONITORING COMMITTEE
NURSING REVIEW SHEET
PROTOCOL NUMBER/TITLE:
Codes: 1=acceptable;
2=not acceptable;
Area
Score
3=acceptable with resolution of issues below
Nurses Notes: (This area will not be transcribed in PRMC minutes, see below)
Protocol Eligibility
Study Parameters
AE Reporting
Drug Procurement
Records to be Kept
Patient Consent Form Present?
Protocol Acceptable?
Issues to be addressed by sponsor and/or PI:
Major (written responses required):
1.
Minor (written responses NOT required):
1.
Print Name:
Signature:
Date:
Please fax/scan this signed coversheet in addition to emailing to [email protected]
11100 Euclid Avenue Cleveland, Ohio 44106-5061 Phone 216-286-2294 Fax 216-201-4043
Case Comprehensive Cancer Center
is a Comprehensive Cancer Center, as designated by the National Cancer Institute
Template version: March 2016