Q1-2: Recipient Information

Question 1: Is the recipient participating in a clinical trial?

Indicate Yes, No, or Unknown if the recipient has consented to any new clinical trial in this reporting period.

Submit a ticket through CIBMTR Center Support when there are questions on reporting clinical trials.

* Reporting Multiple Clinical Trials
FormsNet3SM application: Complete Specify the Clinicaltrials.gov identification number question for each clinical trial the recipient was consented to in this reporting period by adding additional instance(s) in FormsNet3^SM.
Paper form submission: Copy and complete the Specify the Clinicaltrials.gov identification number question for each clinical trial the recipient was consented to in this reporting period in this reporting period

Question 2: Specify the Clinicaltrials.gov identification number

Clinical trials are required to be registered on the clinicaltrials.gov website and will have an associated identification number.

Report the identification number – do not include the letters “NCT,” preceding the digits.

Section Updates:

Question Number	Date of Change	Add/Remove/Modify	Description	Reasoning (If applicable)
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