25. Please indicate which ype of utrascund is avaible at your se mode utrasound We Duplex ultrasound + win ute dele We + oor imazing yee N0 Manufacturer and year entered ints serve —— Probete) Range otimaging tequences ae + naar probe rye requences: + Cunitinear probe: ove tyes requenciess + Sect probe: vee tye, raquenses: 254, Please incente which of ho folowng ar uted fo rcaring compression trans exam (chee ‘hater appteabe) F cD ROw or ovo-RoM Now vdbotapes (VHS or SVS: preferably VES) Format of CO-ROM oF DVD-ROM ‘Sete26a, Please indicate which of the fllowing are wtiized for racerding comprossion utrasound exams (chock al that are appicable) CO-ROM or DVD-ROM © Now videotapes (VHS or SVHS- preferably VHS) Format of CD-ROM or DVD-ROM MPEG files FP MOv fies (Cuick me) REAL video DivKeneaded AVI video © DICON fie Format of videotape PAL TSECAM Pnrse you have indicated vdootape only, i there possibilty you could uttze COIOVD exclusively or be able to convert fo CD or DVD prior io submission ofthe exam? Yes No25b. Moving images are required for his study (not sti frames). Does your institution have the ability to record moving sequences? © ¥e8 No 25c. Hove you previously submited moving sequences forthe purposes ofa cfrical tal? Yes Ono 254, How many vascular ulrascund examinations are conducted at your ste per year? ‘per year 20, How many ultrasound examinations for elinical suspicon of loner Imm vein thrombosis are performed at your ste por year? ‘#peryear ‘The study will employ a systematic, bilateral compression ultrasound examination of the proximal veins of the logs. This procedure willbe performed twice in most study subjects. your sta is eligible {0 participate, you wil be provided with detaled instructions for this procedure, 26. Vil you be wing to partom a sample bistral compression ukrasouns examination according 10 ‘specications, and provice a recording ofthis procedure for quatfcaton? Yee No23, For this protocol, meeting the study endpoint wil depend on the completion of scheduled ultrasounds er patient: one betwoen day 5-14 afer randomsaten (when parenteral study drug it discontinued) ard ona tay 35.Do you foresee any isaue in having bot cf these ulrasouncsscheced / performed on gach pation © ves CN 23a, Please explain if you answered Yes! to question 23: 24, Will more than one qualified individual be avaiable to perform the venous ultasound scheduled ‘sxarinations? Ye oN ‘24a, What ara the quaffcations of the individuals wha porferm these examinations? ‘24, Who interprets the examination? 24e. How does your departmant schedule thees exams to ensure they are completed inthe tinetiame: required by the protocol and according to protacoF? (note procedure may difer from standard of care at your inabtuton)