Registry consent · Administrative
Registry consent
Aug 24, 2026 · TCPT Clinical Research Office · 1 page
G2 › Ferreira, Sam › Administrative › 2026-08-24 Registry consent
Enrolled in the IRB-approved prospective registry.C-6
Sam Ferreira
Packet ready
72 M · MRN TCPT-0046915 · Prostate adenocarcinoma, favorable intermediate risk, cT1c N0 M0
Humana Gold Plus HMO (Medicare Advantage) · H55120937
Ordered by R. Lee, MD · Sep 2, 2026 · CPT 77523 · C61 Malignant neoplasm of prostate