MONICA Manual, Part V, Section 1

Data Transfer
PROBLEM COMMUNICATION FORM
Form: P
Version: 1        29.4.86 		FOR MDC USE ONLY
Seq.no:

Received:
Filed:
A.
Use of this form initiated by: 1 = MONICA Collaborating Centre (MCC)
2 = MONICA Data Centre (MDC)		 |__|
B.
The problem is communicated between MDC and the following MCC:
Name_______________________ Code |__|__|
C.
Date when parts A to F of this form completed (day, month, year) |__|__||__|__||__|__|
PROBLEM
D.
The problem concerns: 1 = paper form, a copy of which is attached
2 = data submitted on a magnetic tape
3 = something else		 |__|
E.
Description of the problem (attach additional sheets, if necessary):
F.
Person completing parts A to E of this form: _____________________________
(Please type or print)
Signature _____________________________
SOLUTION
G.
Solution (attach additional sheets, if necessary):
H.
Person completing part G of this form: __________________________
(Please type or print)
Signature __________________________ Date ____/____/____
day  month  year

Instructions

This form has been designed to simplify the communication concerning all kinds of problems between the MCCs and the MDC. In many situations it can be used as a substitute to a letter, and is often likely to reach the person it concerns at the MDC more quickly than an ordinary letter.

This form is used for reporting or inquiring problems concerning MONICA Data submitted from the MONICA Collaborating Centre (MCC) to the MONICA Data Centre (MDC) for which there is no specific Error Correction Form available. (Error Correction Form for the Population Demographics Reporting Form, Error Correction Form for the Annual Mortality Reporting Form, Manual Error Correction Form for Data Transferred on a Magnetic Tape or Computer Generated Error Correction Form for Data Transferred on a Magnetic Tape are available.) Such problems include illegal records, errors in record identification items on data submitted on a magnetic tape, lost forms, delays in data transfer etc.

The use of the form can be initiated either by the MCC or the MDC, whoever discovered the problem. The initiator completes parts A to F. For example, when a problem communication form is initiated by your MCC, please complete the PROBLEM section. The SOLUTION section is then reserved for the MDC response.

A Problem Communication Form initiated by the MCC should be sent to the MDC, who is expected to complete the SOLUTION section without delay and then return a copy of the completed form to the MCC. A Problem Communication Form initiated by the MDC should be sent to the MCC. The MCC is expected to complete the SOLUTION section without delay, to keep a copy of the completed form and to return the original to the MDC.

Use of PACKING LIST with a PROBLEM COMMUNICATION FORM: A PROBLEM COMMUNICATION FORM needs to be accompanied by a PACKING LIST only if the problem concerns data which has already been sent to the MDC. Hence, for example, it is not necessary to include a PACKING LIST with a notification of delay in data transfer.

General instructions for completing form

This form can be completed either by typewriter or by hand. In either case the recorded information should be examined carefully for both correctness and legibility. Further, since it may be necessary to photocopy the form, perhaps several times, as a routine part of processing and to provide reserve copies it is essential that the recorded information be clear and dark. Hence, please use a dark ribbon if a typewriter is used or a dark ball-point pen if the form is completed by hand.

This form includes blank spaces where you are to record the requested information. None of these spaces should be left blank. If you have no information to provide for a specific item, then so indicate according to the instructions for that item.

If a mistake is made in entering information on the form, please draw a single line through the erroneous entry and provide the correct information in the immediate neighbourhood. If the number of corrections required has made the form difficult to read or perhaps confusing, please re-enter the information on a new copy and send this new copy of the form.

Specific instructions for each item

These instructions should be followed carefully when completing the indicated version of the Problem Communication Form. Please ensure that the instructions are for the version of the form being completed. Specific instructions are listed by item below:

Item A

A.
Use of this form initiated by: 1 = MONICA Collaborating Centre (MCC)
2 = MONICA Data Centre (MDC)		 |__|

Code 1 in the box if the form is initiated by the MCC.
Code 2 in the box if the form is initiated by the MDC.

Item B

B.
The problem is communicated between MDC and the following MCC:
Name_______________________ Code |__|__|

Print or type the official name and code number of the MCC with which the problem is communicated. Use the name and the code number as they appear in Part I,  Appendix 2: MONICA Collaborating Centres and Reporting Units.

Item C

C.
Date when parts A to F of this form completed (day, month, year) |__|__||__|__||__|__|

Give here the date when the PROBLEM part of the form is being filled. Code the day in the first two boxes, the month in the middle two boxes and the last two digits of the year in the last two boxes. For days or months 1 - 9, code 01 - 09. Please do not leave blanks in this item.

Item D

D.
The problem concerns: 1 = paper form, a copy of which is attached
2 = data submitted on a magnetic tape
3 = something else		 |__|

Code 1 in the box to the right if the problem concerns data submitted to the MDC on a paper form. To identify the form in question please attach a copy to the Problem Communication Form.

Code 2 if the problem concerns data submitted to the MDC on a magnetic tape or diskette.

If neither 1 nor 2 applies to the problem please code 3.

Item E

E.
Description of the problem (attach additional sheets, if necessary):

Describe the problem in detail. If necessary, attach additional sheets or a marked copy of a form etc. The number of attachments should be indicated in item E.

In particular, make sure to enter clear and unique identification of the record etc. which the problem concerns.

Item F

F.
Person completing parts A to E of this form: _____________________________
(Please type or print)
Signature _____________________________

Type or print the name and give the signature of the person completing parts A to E of this form.

Item G

G.
Solution (attach additional sheets, if necessary):

Describe here in detail the solution to the problem. Note also any action taken, such as error correction etc. If necessary, use additional sheets. The number of attachments should be indicated in item G.

Item H

H.
Person completing part G of this form: __________________________
(Please type or print)
Signature __________________________ Date ____/____/____
day  month  year

Type or print the name of the person completing part G of this form. Give also the signature and date.