Our main purpose is to help the Pharmaceutical Companies and Contract Research Organizations to find the right Physician Investigator to assure the rapid and accurate completion of the clinical trial.
Valuable Investigators Database Concept Research
Pre-Study Assessmen Questoinnaire
Country: ROMANIA City: .......................... Participant name: .......................... Participant speciality: .......................... Participant title: .......................... Practice: □ Private □Public □Hospital □Specialized Clinic □SMO □Other……….
Institution name: .......................... Institution address: .......................... Phone number: .......................... Fax number: .......................... E-mail: ..........................
Location
1.Location where study subjects are seen: Center Name ............................. Town/City .................................
2.Will subjects be seen at multiple locations? ( ) Yes ( ) No
3.If your site is part of an investigator network, please choose response below: ( ) Site management organization ( ) Academic investigator network ( ) Medical Networks ( ) Other type of investigator network (specify)
4.Please list name of network: ………………………………...............……
5.Did your site have a special room with freezer and refrigerator for study medication, with limited acces? ( ) Yes ( ) No Comments :……………………………………………………………………………
6.Did your site have from MoH the Clinical Trials Authorisation? (Please answer to this question only if you don’t have clinical trials experience) ( ) Yes ( ) No Comments :……………………………………………………………………………
7.At your site do you have special cabinets for keeping the trials documentations with limitted access? ( ) Yes ( ) No Comments :…………………………………………………………………………… |
Dear participant thank you very much for giving us a more deep insight into the acceptance and practicability of the planned clinical study and your potential for participating. Please don’t hesitate to give us any further comments to the planned project.
All your answers will be summarized and reported anonymously on a per country basis.
PERSONAL DATA OR PRIVACY PROTECTION
Please be advised that VID Concept Research must track and electronically maintain certain information associated with Investigators and sites in order to perform
expected duties on behalf of its Sponsors, such as Investigator selection and ongoing project management. In compliance with applicable personal
data protection or privacy principles, VID Concept Research is hereby informing you that personal information you provide to us may be maintained in this way and
may be transferred to the Sponsor, or other regulatory bodies. The information to be maintained includes, but is not limited to the following:
• Investigator name and contact information
• Other relevant information to allow selection for appropriate projects in the future