PVD Form 187 Annual Follow-Up - Cleveland Clinic: Fill out & sign online

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Click ‘Get Form’ to open it in the editor.
Begin by entering the Identification Number and Alphacode in the designated fields. These identifiers are crucial for tracking participant data.
Input the Status Date using the mm/dd/yyyy format to ensure accurate record-keeping.
For Vital Status, select the appropriate option (0 for Dead, 1 for Alive, or 9 for Unknown). If applicable, provide the Date of Death and Reported Cause of Death in the specified fields.
Indicate if the participant received a transplant by selecting from options provided. If yes, enter the date of transplant and type of transplant as required.
Fill in any additional Comments that may be relevant for database entry.
Specify how the status was determined by choosing from the options available.
Finally, complete the form by entering today's date and your username in the respective fields before submitting.

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