Form IE - Inclusion/Exclusion Criteria Not Met
IE - Inclusion/Exclusion Criteria Not Met
Were all eligibility criteria met?	No  Yes
What was the date the eligibility criteria assessment was performed?	01 Jan 2000
IE - Inclusion/Exclusion Criteria Not Met
What was the category of the criterion?	What was the identifier of the inclusion criterion the subject did not meet or the exclusion criterion the subject met?
INCLUSION  EXCLUSION	Choose Inclusion 1 Inclusion 2 Inclusion 3 Exclusion 1 Exclusion 2 Exclusion 3
INCLUSION  EXCLUSION	Choose Inclusion 1 Inclusion 2 Inclusion 3 Exclusion 1 Exclusion 2 Exclusion 3
INCLUSION  EXCLUSION	Choose Inclusion 1 Inclusion 2 Inclusion 3 Exclusion 1 Exclusion 2 Exclusion 3

* Mandatory field