Form HO - Healthcare Encounters
HO - Healthcare Encounters
Were there any healthcare encounters? No  Yes  
What was the healthcare encounter?
If Other, specify
What was the [healthcare encounter/HOTERM] [start/admission] date?
 01 Jan 2000
What was the [healthcare encounter/HOTERM] [end/discharge] date?
 01 Jan 2000
Was the [healthcare encounter/HOTERM] ongoing (as of the [study-specific timepoint or period])? No  Yes  
What was the reason for the [healthcare encounter/HOTERM]?
What was the identifier for the adverse event(s), which precipitated the [healthcare encounter/HOTERM]?
* Mandatory field