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Study Information - Summary

Included VTR Registries
(Limit to 100 words for a 10th grade reading level):

Study Information - Detail

Are you studying the following (check all that apply)
Case Inclusion/Exclusion Criteria
Is a comparison group needed?
Comparison Group Specifications
Services being requested? (Please check at least one option)
(Please limit to 150 words)
Will a codebook or data dictionary be provided?
For tissue requests, what tissue-based studies will you be performing?
Totals for this request:
For tissue requests over 200 total cancer cases, the request will need to be fulfilled over multiple calendar years.

1 Fritz, April, Percy, Constance, Jack, Andrew, Shanmugaratnam, Kanagaratnam, Sobin, Leslie H. et al. (2000). International classification of diseases for oncology, 3rd ed. World Health Organization. (View PDF External Web Site Policy )

2 Fritz A., Percy C., Jack A., Shanmugaratnam K., Sobin L., Parkin D.M., S. Whelan, eds. International Classification of Diseases for Oncology (ICD-O). Third Edition, Second Revision Morphology. International Association of Cancer Registries. http://www.iacr.com.fr/index.php?option=com_content&view=category&layout=blog&id=100&Itemid=577 External Web Site Policy

Investigator Information

Institution Type:

Funding Status

Does this project currently have funding (as of submission date of this form)?
Are you planning to submit a grant application to any of the below: