2814: Indication for CRID Assignment

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
  

!Reporting a subsequent transplant using the indication form is not allowed. Report the subsequent transplant on the latest follow up form for the most recent transplant.

Another Form 2814 would not be required for interventions such as subsequent transplant or subsequent round of cellular therapy.

Q1: Indication
Q2-5: Hematopoietic Cellular Transplant
Q6: Cellular Therapy
Q7: Marrow Toxic Injury
Q8-10: Non-Cellular Therapy

Manual Updates:
Sections of the Forms Instruction Manual are frequently updated. The most recent updates to the manual can be found below.

Date	Manual Section	Add/Remove/Modify	Description
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.

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CIBMTR®(Center for International Blood and Marrow Transplant Research®) is a research collaboration between the National Marrow Donor Program®/Be The Match® and the Medical College of Wisconsin