CIMA Data Collection Forms
Index of Forms

 

Record Type & Form Name Number of Pages
Record 1 (Clinical Adverse Events) 2 pages
Record 2 (Airwatch Quality Control) 1 page
Record 3 (Beta-Agonist Reversibility Testing) 1 page
Record 4 (Biological Quality Control) 1 page
Record 5 (Compliance) 1 page
Record 6 (Diary Card) 1 page
Record 7 (Eligibility Checklist 1) 1 page
Record 8 (Eligibility Checklist 2) 1 page
Record 9 (Eligibility Checklist 3) 1 page
Record 10 (Eligibility Checklist 4) 2 pages
Record 11 (Laboratory Tests) 4 pages
Record 12 (Long Physical Exam) 2 pages
Record 13 (Lung Function Screening) 1 page
Record 14 (Medical History) 4 pages
Record 15 (Methacholine Challenge Testing) 2 pages
Record 16 (Methacholine Test Screening) 1 page
Record 17 (Quality of Life Questionnaire) 4 pages
Record 16 (Short Physical Exam) 1 page
Record 17 (Significant Asthma Exacerbation) 3 pages
Record 18 (Allergy Skin Test Results) 2 pages
Record 19 (Termination of Study Participants) 1 page
Record 20 (Treatment Failure) 2 pages

 






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