The Case Report Form Template from WPForms simplifies gathering critical data for case reporting. Use this template to record all protocol-related information on a subject in clinical trial research.
What Is the Main Purpose of this Case Report Form Template?
The primary purpose of this Case Report Form template is to organize and track vital information for clinical trials efficiently. It supports healthcare professionals and researchers by streamlining data collection and analysis.
The initial section of the form allows users to input critical details, such as the investigator’s name, contact information, case ID/number, and the date of case entry. It even records essential patient information, including their name, age, gender, ID/number, medical history, and inclusion/exclusion criteria.
There is also a Baseline Assessment section where users can record vital signs, medications, weight, height, and other baseline measurements. This establishes a foundation for monitoring the patient’s condition throughout the case.
The Treatment Information part of the form allows for recording the participant’s health issue, their symptoms, severity level, the treatment they are receiving, its frequency and dosage, and the date treatment commenced.
With the Laboratory Tests section, the form provides a space for documenting the outcomes of any medical examinations such as blood tests, urine tests, or imaging. This promotes the comprehensive recording of diagnostic procedures and their influence on the trial.
The form also has a designated space for noting information about follow-up visits. This includes the date of the visit, what procedures were performed, any alterations in treatment, and whether the prescribed plan was followed.
In the Conclusion and Recommendations section, the form allows for a summary of the study findings and suggests further actions based on the data analysis. The signature of the person conducting the study and the date of data entry to verify the report.
Sign up with WPForms today and gain access to this Case Report Form template, as well as a wide range of other customizable templates designed to meet research and reporting needs. Together, let’s make a difference in the field of healthcare and research!
