MaRISS Patient Day 30 (+/-7) Patient Day 30 (+/-7) Patient Day 30 (+/-7) Patient Day 90 (+/-10) Patient Day 90 (+/-10) Patient Day 90 (+/-10) Patient ID # Telephone call Contacted Telephone call Contacted Telephone call Contacted Telephone call Contacted Telephone call Contacted Telephone call Contacted 1st Contact (Yes/No) 2nd Contact (Yes/No) 3rd Contact 1st Contact (Yes/No) 2nd Contact (Yes/No) 3rd Contact (Yes/No) (Yes/No) Attempt Date Attempt Date Attempt Date Attempt Date Attempt Date Attempt Date and initials and initials and initials and initials and initials and initials
MaRISS Patient ID # Day 30 (+/-7) Telephone call 1st Contact Attempt Date and initials Patient Contacted (Yes/No) Day 30 (+/-7) Telephone call 2nd Contact Attempt Date and initials Patient Contacted (Yes/No) Day 30 (+/-7) Telephone call 3rd Contact Attempt Date and initials Patient Contacted (Yes/No) Day 90 (+/-10) Telephone call 1st Contact Attempt Date and initials Patient Contacted (Yes/No) Day 90 (+/-10) Telephone call 2nd Contact Attempt Date and initials Patient Contacted (Yes/No) Day 90 (+/-10) Telephone call 3rd Contact Attempt Date and initials Patient Contacted (Yes/No)
Patient%20Telephone%20Contact%20Log.docx