PHS Inclusion Enrollment Report This report format should NOT be used for collecting data from study participants. *Study Title (must be unique): *Delayed Onset Study? Yes No If study is not delayed onset, the following selections are required: Enrollment Type Planned Cumulative (actual) Using an Existing Dataset or Resource Yes No Enrollment Location Domestic Foreign Clinical Trial Yes No NIH-Defined Phase III Clinical Trial Yes No Comments: Ethnic Categories Not Hispanic or Latino Hispanic or Latino Unknown/Not Reported Ethnicity Racial Categories Total Unknown/ Unknown/ Unknown/ Female Male Female Male Female Male Not Reported Not Reported Not Reported American Indian/ Alaska Native Asian Native Hawaiian or Other Pacific Islander Black or African American White More than One Race Unknown or Not Reported Total
PHS Inclusion Enrollment Report This report format should NOT be used for collecting data from study participants. *Study Title (must be unique): *Delayed Onset Study? Yes No If study is not delayed onset, the following selections are required: Enrollment Type Planned Cumulative (actual) Using an Existing Dataset or Resource Yes No Enrollment Location Domestic Foreign Clinical Trial Yes No NIH-Defined Phase III Clinical Trial Yes No Comments: Racial Categories Ethnic Categories Not Hispanic or Latino Hispanic or Latino Unknown/Not Reported Ethnicity Total Female Male Unknown/ Not Reported Female Male Unknown/ Not Reported Female Male Unknown/ Not Reported American Indian/ Alaska Native Asian Native Hawaiian or Other Pacific Islander Black or African American White More than One Race Unknown or Not Reported Total
2018-ccts-kl2-phs-inclusion-enrollment-report-002-2018.docx