Q1 – 5: Physical Assessments

*Date of Last Report Definition
If completing this form for the 100-day reporting period, “date of last report” should be interpreted as “day 0 (i.e., infusion).”

Question 1: Date of evaluation

Report the date of the most recent physical evaluation where both the abdominal girth and blood pressure were assessed in the reporting period. This evaluation will be used to answer Abdominal girth and Blood pressure.

!Abdominal girth
Abdominal girth is currently disabled and cannot be answered at this time.

Questions 2 – 3: Abdominal girth

Indicate if the recipient’s abdominal girth was measured on the date of evaluation specified in the question above. If Known, specify the recipient’s abdominal measurement in centimeters. If the recipient’s abdominal girth was not measured or if no information is available, select Unknown.

Questions 4 – 5: Blood pressure

Indicate if the recipient’s blood pressure was assessed on the date of evaluation specified above. If assessed, report Known and provide the recipient’s blood pressure. If the recipient’s blood pressure was not measured or if no information is available to determine if the recipient’s blood pressure was measured, select Unknown.

Section Updates:

Question Number	Date of Change	Add/Remove/Modify	Description	Reasoning (If applicable)
Q2	1/24/2025	Modify	Abdominal Girth red warning box above Q2 updated: p(banner important). Abdominal girth and Blood Pressure: Abdominal girth and blood pressure are is currently disabled and cannot be answered at this time.	Due to change in form validation

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CIBMTR® (Center for International Blood and Marrow Transplant Research) is a research collaboration between the Medical College of Wisconsin and NMDP.