Form:	Canary: PASS Missed Visits v3.0

CDE ID	CDE Description
* 421	EDRN Participant ID (Go To: 1390)
* 1390	Follow-up visit missed: (Go To: 423)
	Permissible Values (value): Y1V06 (20)
	Y1V12 (21)
	Y2V06 (22)
	Y2V12 (23)
	Y3V06 (24)
	Y3V12 (25)
	Y4V06 (26)
	Y4V12 (27)
	Y5V06 (28)
	Y5V12 (29)
	Y6V12 (51)
	Y7V12 (53)
	Y8V12 (55)
	Y9V12 (57)
	Y10V12 (59)
* 423	EDRN Protocol ID (Go To: 422)
* 422	EDRN Site ID (Go To: 929)
* 929	EDRN Staff ID of the person who collected the data: (Go To: 1389)
* 1389	Reason for missed visit: (Go To: 1097)
	Permissible Values (value): Participant too ill (1)
	Participant temporarily away from area (2)
	Scheduling problem (3)
	Unable to contact participant (4)
	Other, specify: (97) (Go To: 2185)
* 2185	Reason for missed visit (Other, specify): (Go To: 1097)
1097	Comments (do not include any participant identifiers) (Go To: End of Form)