Plaque Psoriasis Medical History


This example CRF shows data collected about plaque psoriasis medical history.


The CRF was used in a study where all subjects were required to have a diagnosis of plague psoriasis at entry.


Plaque Psoriasis Medical History
Psoriasis Medical History
Medical History Category
What was the date of diagnosis of plaque psoriasis?
 01 Jan 2000
Medical History Term
Medical History Event Date Type
Medical History Event Pre-Specified
Medical History Event Occurrence
Medical History Term
Medical History Event Date Type
Medical History Event Pre-Specified
Did the subject have a flare in the last 6 months? Yes  No  
Evaluation Interval
Chronological Order
Start Date
 01 Jan 2000
Is the most recent flare ongoing? Yes  No  
End Date
 01 Jan 2000
* Mandatory field