The Indication for CRID Assignment (Form 2814) collects information to initiate CIBMTR reporting on appropriate research or data collection forms. This form must be completed for the first indication requiring the individual to register for a CIBMTR Research ID (CRID). Subsequent interventions of the same indication – hematopoietic cellular transplant, non-transplant cellular therapy, marrow toxic injury, and non-cellular therapy – do not require an additional Form 2814; however, a subsequent, new indication may require completion of another Form 2814. Examples of an indication change that would require completion of another Form 2814 include:
- Transplant recipient becomes a marrow toxic injury RITN patient
- Cellular therapy recipient becomes a marrow toxic injury RITN patient
- Marrow toxic injury RITN patient receives cellular therapy or transplant
- Non-cellular therapy patient with any indication change
Q1: Indication
Q2-5: Hematopoietic Cellular Transplant
Q6: Cellular Therapy
Q7: Marrow Toxic Injury
Q8-10: Non-Cellular Therapy
Manual Updates:
The most recent updates to the manual can be found below. Please note, the below updates were to the Forms Instruction Manual. All updates to the 2804 will now be documented in FormsNet3 Instructions.
| Date | Manual Section | Add/Remove/Modify | Description |
|---|---|---|---|
| 11/1/2021 | 2814: Indication for CRID Assignment | Update | Updated instructions to coincide with the Fall 2021 Release |
| 8/3/2020 | 2814: Indication for CRID Assignment | Add | Provided instructions on generating an on demand F2814 Centers should now create an on demand indication form (2814) to report a subsequent infusion when there are NO follow up forms (F2100, F2450 or F4100) available to report this information. |
| 7/31/2020 | 2814: Indication for CRID Assignment | Add | Provided instructions in question 1 on which option to select if the infusion is gene therapy: If the infusion type is gene therapy, select “Hematopoietic cellular transplant.” |
| 7/31/2020 | 2814: Indication for CRID Assignment | Add | Added the blue information box above question 1 notifying that if the infusion is gene therapy, the recipient will be placed on the HCT CRF track: Gene Therapy: If the infusion type is a gene therapy, the recipient will be placed on the HCT CRF track. |
| 4/6/2020 | 2814: Indication for CRID Assignment | Add | Added sentence to question 5 providing guidance on when to select ‘no’. |
| 1/29/2020 | 2814: Indication for CRID Assignment | Add | Added the following instruction for how to report the date of transplant for intrauterine transplants: Intrauterine Transplants For intrauterine transplants, report the date of birth as the date of transplant to avoid errors from occurring in FormsNet3SM. |
| 4/26/19 | 2814: Indication for CRID Assignment | Modify | Version 3 of the 2814: Indication for CRID Assignment section of the Forms Instructions Manual released. Version 3 corresponds to revision 3 of the Form 2814. |